Blue River Health & Wellness, PLLC
NPI 1356073852ActiveOrganization· Nurse Practitioner, Family· Fort Mohave, AZ
Nurse Practitioner, Family in Fort Mohave, Arizona, registered in NPPES in June 2022. The authorized official on file is Nicole Ann Roberts, FNP, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1356073852 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 24, 2022 |
| Last updated in NPPES | Jun 24, 2022 |
| Certified by provider | Jun 24, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | — | — |
| Clinic/Center | 261Q00000X | — | — |
| Nurse Practitioner, Psych/Mental Health | 363LP0808X | — | — |
| Nurse Practitioner, Primary Care | 363LP2300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AZ) |
|---|
Other family nurse practitioners in Fort Mohave
- 1164988135
- 1891388856
- 1972158624
- 1306187158
- 1386485712
- 1528421971
- 1558728055
- 1114325784
- 1144704933
- 1750116240
- 1912728965
- 1174121883
All 19 family nurse practitioners in Fort Mohave · All family nurse practitioners in Arizona