Provider Demographics
NPI:1033187802
Name:BELINSKY, JACQUELYN (CNP)
Entity Type:Individual
Prefix:
First Name:JACQUELYN
Middle Name:
Last Name:BELINSKY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 SAINT MICHAELS DR
Mailing Address - Street 2:PHYSICIAN PRACTICES
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-7601
Mailing Address - Country:US
Mailing Address - Phone:505-995-4901
Mailing Address - Fax:
Practice Address - Street 1:2025 GALISTEO ST
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-2101
Practice Address - Country:US
Practice Address - Phone:505-995-4901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR39419363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
10010584OtherLOVELACE
NMNM006950OtherBCBS NM
201038480OtherPRESBYTERIAN HEALTH PLANS
NM48059889Medicaid
QMYPR0068044OtherMOLINA
2511164OtherUHC
NM341412809Medicare PIN