Individual
MS. B J BECKERRN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6283 RIESCH RD, WEST BEND, WI 53095-9106
(262) 334-1021
(262) 334-0556
Mailing address
6283 RIESCH RD, WEST BEND, WI 53095-9106
(262) 334-1021
(262) 334-0556
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
39979100
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3095070
PRIOR AUTHROIZATION #
WI
Enumeration date
01/16/2007
Last updated
07/09/2007
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