Healthcare Provider Details

I. General information

NPI: 1730571993
Provider Name (Legal Business Name): BELINDA WATSON FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2015
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17063 W GREENWAY RD # 102
SURPRISE AZ
85388-9605
US

IV. Provider business mailing address

261 N ROOSEVELT AVE
CHANDLER AZ
85226-2617
US

V. Phone/Fax

Practice location:
  • Phone: 480-677-8282
  • Fax: 844-470-2777
Mailing address:
  • Phone: 480-677-8282
  • Fax: 844-470-2777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number247233
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN126450
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: