Individual
DONNA BECKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
500 CHERRY ST, BLUEFIELD, WV 24701-3306
(304) 327-1100
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-4342
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
36473
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001836212
WV BC/BS
WV
05
—
010354005
—
VA
01
—
1068121
WV DWC
WV
01
—
3810002565
WV MCD
WV
01
—
P00378828
RR MEDICARE
—
Enumeration date
05/19/2006
Last updated
02/17/2009
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