Provider Demographics
NPI:1366855421
Name:BECK, INGRID ANDERSON
Entity type:Individual
Prefix:
First Name:INGRID
Middle Name:ANDERSON
Last Name:BECK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:INGRID
Other - Middle Name:
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1309, MAILSTOP 21110Q
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55425
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3930 NORTHWOODS DRIVE
Practice Address - Street 2:MAIL STOP 32800A
Practice Address - City:ARDEN HILLS
Practice Address - State:MN
Practice Address - Zip Code:55112-6974
Practice Address - Country:US
Practice Address - Phone:651-523-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-06
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN62431207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine