Individual
MARILYN A. BECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1900 GORDON COOPER DRIVE, SHAWNEE, OK 74801
(405) 878-7160
Mailing address
504 POOL LANE, SHAWNEE, OK 74801
(405) 878-7160
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R0073894
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200072230A
—
OK
Enumeration date
06/17/2006
Last updated
01/27/2010
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