Provider Demographics
NPI:1457669863
Name:ROBERTS, BELINDA (NP)
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:BELINDA
Other - Middle Name:ROBERTS
Other - Last Name:HEERSINK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:222 SOUTHWAY AVE STE C
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ID
Mailing Address - Zip Code:83501-2703
Mailing Address - Country:US
Mailing Address - Phone:208-746-1333
Mailing Address - Fax:208-746-8090
Practice Address - Street 1:222 SOUTHWAY AVE STE C
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ID
Practice Address - Zip Code:83501-2703
Practice Address - Country:US
Practice Address - Phone:208-746-1333
Practice Address - Fax:208-746-8090
Is Sole Proprietor?:No
Enumeration Date:2010-09-20
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201050183NP363LF0000X
IDNP-1080A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily