Provider Demographics
NPI:1992145056
Name:BECKLEY, JEANNE MARIE (NNP)
Entity type:Individual
Prefix:
First Name:JEANNE
Middle Name:MARIE
Last Name:BECKLEY
Suffix:
Gender:
Credentials:NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 OPEN AIR LN
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-2290
Mailing Address - Country:US
Mailing Address - Phone:919-624-8332
Mailing Address - Fax:
Practice Address - Street 1:5524 HOSPITAL N
Practice Address - Street 2:BOX 100500 MEDICAL CENTER
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-979-9755
Practice Address - Fax:919-681-6065
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-03
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC108065363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care