Provider Demographics
NPI:1427433176
Name:BECKER, BETSY MARIE (NP)
Entity type:Individual
Prefix:MRS
First Name:BETSY
Middle Name:MARIE
Last Name:BECKER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:BETSY
Other - Middle Name:MARIE
Other - Last Name:PARSONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:5515 CLEVELAND AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49127-9670
Mailing Address - Country:US
Mailing Address - Phone:269-429-6604
Mailing Address - Fax:269-429-1715
Practice Address - Street 1:5515 CLEVELAND AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:STEVENSVILLE
Practice Address - State:MI
Practice Address - Zip Code:49127-9670
Practice Address - Country:US
Practice Address - Phone:269-429-6604
Practice Address - Fax:269-429-1715
Is Sole Proprietor?:No
Enumeration Date:2015-07-23
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4704314832363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner