Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Belinda Fomba

Individual provider Registered Nurse · NPI 1194434738

Belinda Fomba is a Nurse Practitioner in Fort Defiance, Arizona. Qualified in 2022, 4 years ago. Practices with Family Care Center LLC, a 693-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Arizona.

Years since qualifying
4
Licensed in
AZ
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

Corner Of Route N12 And N7
Fort Defiance, AZ 86504-0649
Phone: (928) 729-8000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 219337 (AZ)
Registered Nurse Taxonomy 163W00000X · Licence 219337 (AZ)

Record details

NPI number1194434738
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedNovember 22, 2022
Last updated in NPPESMay 4, 2023
Certification dateApril 25, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Family Care Center Llc — 693 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Fort Defiance