Provider Demographics
NPI:1063667681
Name:LARGE, BELINDA J (PNP)
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:J
Last Name:LARGE
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:BELINDA
Other - Middle Name:J
Other - Last Name:SPINKS-LARGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PNP
Mailing Address - Street 1:3200 E CAMELBACK RD STE 250
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-2327
Mailing Address - Country:US
Mailing Address - Phone:602-933-1814
Mailing Address - Fax:
Practice Address - Street 1:1919 E THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-7710
Practice Address - Country:US
Practice Address - Phone:602-933-2311
Practice Address - Fax:602-933-4269
Is Sole Proprietor?:No
Enumeration Date:2008-11-24
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP 1941363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine