Basic Information
| Provider Information | |||||||||
| NPI: | 1841794658 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAND | ||||||||
| FirstName: | BELINDA | ||||||||
| MiddleName: | ANNE | ||||||||
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| Credential: | CPNP-PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 26666 | ||||||||
| Address2: | |||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871256666 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5059236770 | ||||||||
| FaxNumber: | 5059235354 | ||||||||
| Practice Location | |||||||||
| Address1: | PRESBYTERIAN MEDICAL GROUP, PEDIATRICS | ||||||||
| Address2: | 4005 HIGH RESORT BLVD SE | ||||||||
| City: | RIO RANCH | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871240000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052912770 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/19/2018 | ||||||||
| LastUpdateDate: | 04/26/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | CNP-03511 | NM | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 06822711 | 05 | NM | MEDICAID |