Provider Demographics
NPI:1962101683
Name:BECKFORD, AMANDA LINN (RN)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LINN
Last Name:BECKFORD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:843 AUTUMN AVE
Mailing Address - Street 2:
Mailing Address - City:CAREY
Mailing Address - State:OH
Mailing Address - Zip Code:43316-3505
Mailing Address - Country:US
Mailing Address - Phone:567-230-6013
Mailing Address - Fax:
Practice Address - Street 1:843 AUTUMN AVE
Practice Address - Street 2:
Practice Address - City:CAREY
Practice Address - State:OH
Practice Address - Zip Code:43316-3505
Practice Address - Country:US
Practice Address - Phone:567-230-6013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-02
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH159900163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse