BECKY L WITHAM (NPI# 1386047025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386047025 |
| Entity Type | Individual |
| Full Name | BECKY L WITHAM |
| Credential | FNP-C |
| Practice Address |
1060 W 10th Street Rolla MO 65401 |
| Mailing Address |
1050 W 10th Street Attn: Executive Director of Physician Clinics Rolla MO 65401 |
| Practice Telephone | 5734583324 |
| Practice Fax Number | 5734588445 |
| Mailing Telephone | 5733649000 |
| Mailing Fax Number | 5734262108 |
| Enumeration Date | 2014-10-08 |
| Last Update Date | 2019-08-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
2014035055 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1386047025 | 05 |
| Street Address |
1060 W 10TH STREET |
| City | ROLLA |
| State | MO |
| Zip Code | 65401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639645591 | Samantha Jo Mitchell | Pharmacist | 1375 E 10th St Suite B, Rolla, MO 65401 | 2018-10-18 |
| 1427567726 | Gerry Wade Funkhouser Jr. | Counselor | 103 W 10th St, Rolla, MO 65401 | 2017-09-29 |
| 1366967960 | Shana Hintz Wisniewski | Social Worker | 1000 W. 10th St., Rolla, MO 65401 | 2017-08-04 |
| 1174066559 | Tabitha Hundt | Counselor | 1011 Cypress Dr, Rolla, MO 65401 | 2016-12-02 |
| 1841742855 | Alpha Assisted Living LLC | Assisted Living Facility | 13450 Cr 7040, 803 E 12th St, Rolla, MO 65401 | 2016-10-26 |
| 1275916884 | Elizabeth Zersen | Occupational Therapist | 2053 Vienna Rd, Rolla, MO 65401 | 2015-06-30 |
| 1114326121 | Summer Adey | Licensed Practical Nurse | 13750 State Route F, Rolla, MO 65401 | 2014-08-14 |
| 1518303296 | Leaetta Mildred Gardner | Nursing Facility/Intermediate Care Facility | 13450 County Road 7040, Rolla, MO 65401 | 2013-05-21 |
| 1316282064 | Susan Peitz Gruener | Occupational Therapy Assistant | 1800 White Column Road, Rolla, MO 65401 | 2012-12-06 |
| 1427308667 | Erin Marie Thiltgen | Specialist/Technologist | 806 A State Route 72 East, Rolla, MO 65401 | 2012-09-14 |
| Find all providers in zip 65401 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366644320 | Dawn Renee Tope | Nurse Practitioner | 416 S Bishop Ave, Rolla, MO 65401-4311 | 2007-06-01 |
| 1114007333 | Karene Marie Goodman | Nurse Practitioner | 715 St Rt Cc, Rolla, MO 65401 | 2006-10-16 |
| 1023633096 | Kayla N Kaiser | Nurse Practitioner | 213 2nd Ave Ne, Rolla, ND 58367-7153 | 2020-06-15 |
| 1275098402 | Caitlyn Micah Barry | Nurse Practitioner | 1218 E State Route 72, Rolla, MO 65401-3938 | 2019-02-01 |
| 1811472822 | James Mark Spaw | Nurse Practitioner | 1605 Martin Springs Dr Ste 230, Rolla, MO 65401-2980 | 2018-09-26 |
| 1215414099 | Rachelle Long Fischer | Nurse Practitioner | 213 2nd Ave Ne, Rolla, ND 58367-7153 | 2018-07-24 |
| 1659857415 | Josie Leann Eoff | Nurse Practitioner | 1050 W 10th St, Rolla, MO 65401 | 2018-07-16 |
| 1356847446 | Brayden Walker | Nurse Practitioner | 114 3rd St Ne, Rolla, ND 58367-7137 | 2018-04-05 |
| 1629588314 | Patricia Ann French | Nurse Practitioner | 1000 W 10th St, Rolla, MO 65401 | 2017-10-06 |
| 1497278378 | Ariella Lee Schuler Martin | Nurse Practitioner | 1000 W 10th St, Rolla, MO 65401 | 2017-07-21 |
| Find all providers in ROLLA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.