Individual
JILL KATRICE BECKWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN132814
GA
363LA2200X
Adult Health Nurse Practitioner
Primary
RN132814
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000958075A
—
GA
05
—
000958075C
—
GA
01
—
01376746
AMERIGROUP
GA
01
—
500025280
RR MEDICARE
GA
01
—
567244
WELLCARE
GA
05
—
NP0872
—
SC
01
—
P00903092
RAILROAD MEDICARE
GA
Enumeration date
07/18/2005
Last updated
07/25/2011
Update your record
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