Provider Demographics
NPI:1528466695
Name:BECK, SUZANNE (CRNP)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:BECK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-851-6670
Mailing Address - Fax:717-255-0938
Practice Address - Street 1:3421 CONCORD RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-9001
Practice Address - Country:US
Practice Address - Phone:717-851-6670
Practice Address - Fax:717-255-0938
Is Sole Proprietor?:No
Enumeration Date:2014-12-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014544363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1029896070001Medicaid