Provider Demographics
NPI:1841794658
Name:RAND, BELINDA ANNE (CPNP-PC)
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:ANNE
Last Name:RAND
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26666
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-6666
Mailing Address - Country:US
Mailing Address - Phone:505-923-6770
Mailing Address - Fax:505-923-5354
Practice Address - Street 1:PRESBYTERIAN MEDICAL GROUP, PEDIATRICS
Practice Address - Street 2:4005 HIGH RESORT BLVD SE
Practice Address - City:RIO RANCH
Practice Address - State:NM
Practice Address - Zip Code:87124-0000
Practice Address - Country:US
Practice Address - Phone:505-291-2770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-03511363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM06822711Medicaid