Provider Demographics
NPI:1104176460
Name:BECKWITH, WENDY J (NP)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:J
Last Name:BECKWITH
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:4441 CAPITAL AVE SW
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-9359
Mailing Address - Country:US
Mailing Address - Phone:269-788-6888
Mailing Address - Fax:269-788-6889
Practice Address - Street 1:4441 CAPITAL AVE SW
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-9359
Practice Address - Country:US
Practice Address - Phone:269-788-6888
Practice Address - Fax:269-788-6889
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704169188363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner