Provider Demographics
NPI:1427691039
Name:BELCHER, AUDRA D
Entity type:Individual
Prefix:
First Name:AUDRA
Middle Name:D
Last Name:BELCHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 CITY PARK AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-8326
Mailing Address - Country:US
Mailing Address - Phone:419-810-4845
Mailing Address - Fax:
Practice Address - Street 1:818 CITY PARK AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-8326
Practice Address - Country:US
Practice Address - Phone:419-810-4845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-26
Last Update Date:2019-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide