Provider Demographics
NPI:1174730550
Name:BECHER, JENNIFER LYNN (ADULT NP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LYNN
Last Name:BECHER
Suffix:
Gender:F
Credentials:ADULT NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:VINCENNES
Mailing Address - State:IN
Mailing Address - Zip Code:47591-1022
Mailing Address - Country:US
Mailing Address - Phone:812-885-3703
Mailing Address - Fax:812-885-3707
Practice Address - Street 1:429 S 6TH ST
Practice Address - Street 2:
Practice Address - City:VINCENNES
Practice Address - State:IN
Practice Address - Zip Code:47591-1022
Practice Address - Country:US
Practice Address - Phone:812-885-3703
Practice Address - Fax:812-885-3707
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28120546A363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN210210810Medicaid
IN000000553652OtherANTHEM BLUE CROSS
229770CMedicare PIN