Healthcare Provider Details

I. General information

NPI: 1609364934
Provider Name (Legal Business Name): BELINDA ANN BURDEN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2018
Last Update Date: 04/25/2024
Certification Date: 04/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 RIO BRAVO BLVD SW STE 36
ALBUQUERQUE NM
87105-6060
US

IV. Provider business mailing address

PO BOX 740018
ATLANTA GA
30374-0018
US

V. Phone/Fax

Practice location:
  • Phone: 505-777-3004
  • Fax: 505-808-4990
Mailing address:
  • Phone: 773-352-1517
  • Fax: 312-929-0373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number220777
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP.022674
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number68482
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: