Provider Demographics
NPI:1518553635
Name:ROACHE-BECKFORD, DIONNE ROMONA (NP)
Entity type:Individual
Prefix:
First Name:DIONNE
Middle Name:ROMONA
Last Name:ROACHE-BECKFORD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5211 LOTUS CANYON CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-1446
Mailing Address - Country:US
Mailing Address - Phone:561-275-0575
Mailing Address - Fax:
Practice Address - Street 1:5211 LOTUS CANYON CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-1446
Practice Address - Country:US
Practice Address - Phone:561-275-0575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-13
Last Update Date:2020-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1021682363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner