Provider Demographics
NPI:1316034689
Name:TURNER, ROBERTA LYNN (FNP)
Entity Type:Individual
Prefix:
First Name:ROBERTA
Middle Name:LYNN
Last Name:TURNER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ROBERTA
Other - Middle Name:TURNER
Other - Last Name:HORTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:500 S. 11TH AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201
Mailing Address - Country:US
Mailing Address - Phone:208-239-3815
Mailing Address - Fax:208-239-3814
Practice Address - Street 1:500 S. 11TH AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201
Practice Address - Country:US
Practice Address - Phone:208-239-3815
Practice Address - Fax:208-239-3814
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP463A363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010159283OtherBLUE SHIELD-DOWNEY
ID000010159380OtherBLUE SHIELD-AM FALLS
IDNPYF4OtherBLUE CROSS-POCATELLO
IDNPYF6OtherBLUE CROSS-DOWNEY
ID000010159285OtherBLUE SHIELD-POCATELLO
ID000010159381OtherBLUE SHIELD-ABERDEEN
IDNPYF3OtherBLUE CROSS-ABERDEEN
ID807618400Medicaid
IDNPYJ2OtherBLUE CROSS-MCCAMMON
IDP00434966OtherRAILROAD MEDICARE
ID000010159282OtherBLUE SHIELD-LAVA
ID1316034689Medicaid
IDNPYF2OtherBLUE CROSS-LAVA
IDNPYF5OtherBLUE CROSS-AM FALLS
ID000010159285OtherBLUE SHIELD-POCATELLO
1344202Medicare PIN
ID1344203Medicare PIN
ID000010159282OtherBLUE SHIELD-LAVA
IDP00434966OtherRAILROAD MEDICARE
13442001Medicare PIN