Provider Demographics
NPI:1174596282
Name:BECK-GIFFORD, MICHAEL (NP)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:BECK-GIFFORD
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 BIGHORN RD
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3480
Mailing Address - Country:US
Mailing Address - Phone:970-229-9800
Mailing Address - Fax:970-229-1421
Practice Address - Street 1:2025 BIGHORN RD
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525
Practice Address - Country:US
Practice Address - Phone:970-229-9800
Practice Address - Fax:970-229-1421
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO768363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07810708Medicaid
CO07810708Medicaid
CO024171OtherKAISER COMMERCIAL NUMBER
CO495838Medicare PIN
COP87544Medicare UPIN
CO07810708Medicaid