Individual ProviderKathleen BeckNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address25631 Little Mack Ave Ste 205, Saint Clair Shores, MI 48081-2108(586) 443-2930(947) 522-1848PECOS EnrollmentBased on the most recent information from CMS, provider Kathleen Beck is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1790168136Provider TypeIndividualFull NameBeck, KathleenCredentialNPGenderFemaleSole ProprietorNoEnumeration Date7/2/2015Last Updated11/27/2023Contact InformationPractice LocationPractice Address25631 Little Mack Ave Ste 205, Saint Clair Shores, MI 48081-2108Phone(586) 443-2930FaxUnlisted FaxMailing LocationMailing Address26901 Beaumont Blvd Ste 3d, Southfield, MI 48033-3849Phone(947) 522-1848Fax(947) 522-0307Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense4704260651Michigan