Provider Demographics
NPI:1023621182
Name:BECKMAN, TWILA (LPN)
Entity type:Individual
Prefix:
First Name:TWILA
Middle Name:
Last Name:BECKMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 MIMOSA CT
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29527-5919
Mailing Address - Country:US
Mailing Address - Phone:843-254-7721
Mailing Address - Fax:
Practice Address - Street 1:1011 MIMOSA CT
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29527-5919
Practice Address - Country:US
Practice Address - Phone:843-254-7721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC48526164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse