Provider Demographics
NPI:1821737008
Name:BELTRAN, BRIANDA (PA-C)
Entity Type:Individual
Prefix:
First Name:BRIANDA
Middle Name:
Last Name:BELTRAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2270 S RIDGEVIEW DR STE 204
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-8880
Mailing Address - Country:US
Mailing Address - Phone:928-248-4325
Mailing Address - Fax:
Practice Address - Street 1:2270 S RIDGEVIEW DR STE 204
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-8880
Practice Address - Country:US
Practice Address - Phone:928-248-4325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-03
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant