Provider Demographics
NPI:1700161163
Name:BELTZ, ROY ALLEN (RN)
Entity Type:Individual
Prefix:MR
First Name:ROY
Middle Name:ALLEN
Last Name:BELTZ
Suffix:
Gender:M
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:PSC 827
Mailing Address - Street 2:BOX 331
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09617-9998
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PSC 827
Practice Address - Street 2:BOX 1000
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09617-9998
Practice Address - Country:US
Practice Address - Phone:39081-811-6317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-18
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA769208163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse