Provider Demographics
NPI:1396269809
Name:BECKMAN, JESSICA CAROL (DPT)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:CAROL
Last Name:BECKMAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:CAROL
Other - Last Name:STOENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:PO BOX 306393
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6393
Mailing Address - Country:US
Mailing Address - Phone:615-373-1350
Mailing Address - Fax:615-221-9054
Practice Address - Street 1:3760 OCOEE PL NW STE 101
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-5637
Practice Address - Country:US
Practice Address - Phone:423-336-3795
Practice Address - Fax:423-336-3796
Is Sole Proprietor?:No
Enumeration Date:2017-07-27
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11465225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist