Provider Demographics
NPI:1083972905
Name:PRACHAR, BELINDA ROSE (RN)
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:ROSE
Last Name:PRACHAR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29000 COUNTY ROAD 41
Mailing Address - Street 2:
Mailing Address - City:WILLOW RIVER
Mailing Address - State:MN
Mailing Address - Zip Code:55795-3058
Mailing Address - Country:US
Mailing Address - Phone:218-491-3762
Mailing Address - Fax:218-372-3825
Practice Address - Street 1:29000 COUNTY ROAD 41
Practice Address - Street 2:
Practice Address - City:WILLOW RIVER
Practice Address - State:MN
Practice Address - Zip Code:55795-3058
Practice Address - Country:US
Practice Address - Phone:218-491-3762
Practice Address - Fax:218-372-3825
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-28
Last Update Date:2012-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 167687-3163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse