Provider Demographics
NPI:1104292200
Name:BELCHER-HOWARD, ROBIN D (ARNP)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:D
Last Name:BELCHER-HOWARD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:D
Other - Last Name:BELCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 19249
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32245-9249
Mailing Address - Country:US
Mailing Address - Phone:904-743-1883
Mailing Address - Fax:904-743-5309
Practice Address - Street 1:3333 W 20TH ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32254-1703
Practice Address - Country:US
Practice Address - Phone:904-695-9145
Practice Address - Fax:904-695-2465
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA203866363LP0808X
WAAP61195667363LP0808X
FLARNP9414710363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100314900Medicaid