| Doctor Name: | JORDAN BECKER |
| NPI Number: | 1508107129 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | NP |
| License Number: | 14339-NP |
| Business Practice Address: | 6559 Wilson Mills Rd 106 Mayfield Village, OH - 441436402 |
| Business Phone Number: | 4404491540 |
| Business Fax Number: | 4404602833 |
| Mailing Address: | 9485 Mentor Avenue, Suite 210 Primehealth MENTOR |
| State: | OH |
| Postal Code: | 440608723 |
| Phone Number: | 4402055883 |
| Fax Number: | 4402055746 |
| NPI Enumeration Date: | 03/06/2013 |
| NPI Last Update Date: | 07/28/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 14339-NP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |