Provider Demographics
NPI:1205353786
Name:BECKER, KRISTI ANN (APN, FNP-BC)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:ANN
Last Name:BECKER
Suffix:
Gender:F
Credentials:APN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 ONTARIO DR
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-1269
Mailing Address - Country:US
Mailing Address - Phone:815-355-1231
Mailing Address - Fax:
Practice Address - Street 1:400 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-3814
Practice Address - Country:US
Practice Address - Phone:630-892-4355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-25
Last Update Date:2017-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.016185363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily