Provider Demographics
NPI:1033993407
Name:WHITE, BELINDA ANN
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:ANN
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9836 E TILLMAN AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85212-6512
Mailing Address - Country:US
Mailing Address - Phone:480-212-6991
Mailing Address - Fax:
Practice Address - Street 1:10211 E MADERO AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-1493
Practice Address - Country:US
Practice Address - Phone:480-635-2025
Practice Address - Fax:480-635-2044
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN128917163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool