Healthcare Provider Details

I. General information

NPI: 1831837384
Provider Name (Legal Business Name): BELINDA BERSHU NKAIME PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NA NA

II. Dates (important events)

Enumeration Date: 05/24/2022
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4730 BECKNER RD
SANTA FE NM
87507-3691
US

IV. Provider business mailing address

4730 BECKNER RD
SANTA FE NM
87507-3691
US

V. Phone/Fax

Practice location:
  • Phone: 505-477-1050
  • Fax:
Mailing address:
  • Phone: 505-477-1050
  • Fax: 505-384-2204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number809731
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number68770
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: