Provider Demographics
NPI:1952640385
Name:PRINS, BELVA (PTA)
Entity Type:Individual
Prefix:
First Name:BELVA
Middle Name:
Last Name:PRINS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 7TH ST SE
Mailing Address - Street 2:
Mailing Address - City:WASECA
Mailing Address - State:MN
Mailing Address - Zip Code:56093-3513
Mailing Address - Country:US
Mailing Address - Phone:507-521-1320
Mailing Address - Fax:
Practice Address - Street 1:1575 HOOVER DR
Practice Address - Street 2:
Practice Address - City:NORTH MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56003-2667
Practice Address - Country:US
Practice Address - Phone:507-387-2037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNA231163WR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0400XNursing Service ProvidersRegistered NurseRehabilitation