Individual
STACIE LEIGH BECKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
859 ALDERSON ST, WILLIAMSON, WV 25661-3215
(304) 235-2500
(304) 235-4549
Mailing address
PO BOX 1878, WILLIAMSON, WV 25661-1878
(304) 236-5029
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
WV00960
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95003679
—
KY
Enumeration date
11/09/2006
Last updated
08/27/2008
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