Provider Demographics
NPI:1528789153
Name:CHILDERS, BELINDA ANN (BSN, RN, CCRN, MA)
Entity type:Individual
Prefix:
First Name:BELINDA
Middle Name:ANN
Last Name:CHILDERS
Suffix:
Gender:F
Credentials:BSN, RN, CCRN, MA
Other - Prefix:
Other - First Name:BELINDA
Other - Middle Name:ANN
Other - Last Name:SWOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:815 N 6TH E
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:ID
Mailing Address - Zip Code:83647-2207
Mailing Address - Country:US
Mailing Address - Phone:208-580-2001
Mailing Address - Fax:208-580-9993
Practice Address - Street 1:815 N 6TH E
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:ID
Practice Address - Zip Code:83647-2207
Practice Address - Country:US
Practice Address - Phone:208-580-2001
Practice Address - Fax:208-580-9993
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDN-31978163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse