Provider Demographics
NPI:1942358494
Name:BECK, DARLENE COLLINS (APNP)
Entity type:Individual
Prefix:MS
First Name:DARLENE
Middle Name:COLLINS
Last Name:BECK
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 250953
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53225-6518
Mailing Address - Country:US
Mailing Address - Phone:414-550-6895
Mailing Address - Fax:
Practice Address - Street 1:4655 N PORT WASHINGTON RD STE 325
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53212-1000
Practice Address - Country:US
Practice Address - Phone:414-999-1099
Practice Address - Fax:414-999-0699
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI159799-30163W00000X
WI7043-33363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38349700Medicaid