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General NPI Number Information
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NPI Number | 1316452972
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Entity Type | Organization
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Legal Business Name | C BELCHER MSN, RN, FNP-BC, CEN, LLC
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Dates
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Enumeration Date | 12/05/2017
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Last Update Date | 12/05/2017
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Provider Practice Location Address
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Address Line | 2513 FRED DAUGHERTY AVE
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City | CLOVIS
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State | NM
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Zip | 88101-8615
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Country | US
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Telephone | 575-760-0160
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Fax |
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Provider Business Mailing Address
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Address Line | 2513 FRED DAUGHERTY AVE
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City | CLOVIS
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State | NM
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Zip | 88101-8615
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | CONSTANCE C BELCHER
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Credential |
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Telephone | 575-760-0160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 65513
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License Number State | NM
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