Provider Demographics
NPI:1609686849
Name:BECK, MARTY JEAN
Entity type:Individual
Prefix:
First Name:MARTY
Middle Name:JEAN
Last Name:BECK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4207 BEL AIR DR
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-2321
Mailing Address - Country:US
Mailing Address - Phone:602-459-6094
Mailing Address - Fax:
Practice Address - Street 1:4207 BEL AIR DR
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-2321
Practice Address - Country:US
Practice Address - Phone:602-459-6094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No372600000XNursing Service Related ProvidersAdult Companion