Individual
SALLY ANN BECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4801 VETERANS DR, SAINT CLOUD, MN 56303-2015
(320) 252-1670
(320) 255-6419
Mailing address
4801 VETERANS DR, SAINT CLOUD, MN 56303-2015
(320) 252-1670
(320) 255-6419
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA03524
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
951
PHYSICIAN ASSISTANT
NE
Enumeration date
12/08/2005
Last updated
12/07/2015
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