Provider Demographics
NPI:1063810976
Name:BECKER, ANNA G
Entity type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:G
Last Name:BECKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3511 W MARKET ST
Mailing Address - Street 2:STE A
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27403-4442
Mailing Address - Country:US
Mailing Address - Phone:336-852-3800
Mailing Address - Fax:336-852-5725
Practice Address - Street 1:3511 W MARKET ST STE 250
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-4445
Practice Address - Country:US
Practice Address - Phone:336-852-3800
Practice Address - Fax:336-852-5725
Is Sole Proprietor?:No
Enumeration Date:2014-12-09
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-06994363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant