Blue River Health & Wellness, Pllc

LBN: Blue River Health & Wellness, Pllc
Blue River Health & Wellness, Pllc is an health care organization with primary practice located at 1520 E Hammer Ln Ste 104 , Fort Mohave AZ 86426-6665. The organization recently has 4 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Clinic/Center, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Family is the primary health care specialty. Blue River Health & Wellness, Pllc can be contacted via phone (602) 315-0211, or through Roberts, Nicole Ann via phone (928) 577-2727.

Contact Information

Primary practice address
1520 E Hammer Ln Ste 104 Fort Mohave AZ 86426-6665
Phone: (602) 315-0211
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Roberts, Nicole Ann Family Nurse Practitioner (FNP)
Phone: (928) 577-2727

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X

Profile Details

NPI number 1356073852
LBN Legal business name Blue River Health & Wellness, Pllc
DBA Doing business as
Authorized official Roberts, Nicole Ann Family Nurse Practitioner (FNP)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 24th, 2022
Last updated Jun 24th, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356073852 NPPES
Arizona Other 23375081 CORPORATION ID

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