Individual
BELINDA FOMBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
CORNER OF ROUTE N12 AND N7, FORT DEFIANCE, AZ 86504-0649
(928) 729-8000
Mailing address
PO BOX 649, FORT DEFIANCE, AZ 86504-0649
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
219337
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
219337
AZ
Other
Enumeration date
11/22/2022
Last updated
05/04/2023
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