BLUE RIVER HEALTH & WELLNESS, PLLC
NPI 1356073852
Nurse Practitioner - Family in Fort Mohave, AZ
About Blue River Health & Wellness, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BLUE RIVER HEALTH & WELLNESS, PLLC (NPI 1356073852) is a healthcare organization registered as a family in Fort Mohave, Arizona and active in the NPI registry since June 2022. The organization holds a CLIA Waiver certificate valid through August 30, 2026 and lists Nicole Ann Roberts, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 4
Other Identifiers 1
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 03D2267796
Blue River Health & Wellness, PLLC · Fort Mohave, AZOther Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Blue River Health & Wellness, PLLC's NPI number?
The NPI number for Blue River Health & Wellness, PLLC is 1356073852. It was assigned to this organization in the NPPES registry on June 24, 2022.
Where is Blue River Health & Wellness, PLLC located?
Blue River Health & Wellness, PLLC is located at 1520 E Hammer Ln Ste 104, Fort Mohave, AZ 86426. The listed phone number is (602) 315-0211.
What is Blue River Health & Wellness, PLLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Does Blue River Health & Wellness, PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 03D2267796) is associated with this NPI, valid through August 30, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Blue River Health & Wellness, PLLC was last updated on June 24, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Blue River Health & Wellness, Pllc · NPI 1356073852
Family organization in Fort Mohave, Arizona. Organization record, active in the CMS NPPES registry since June 24, 2022.
## Identity
- **NPI:** 1356073852 (Entity type: Organization)
- **Enumerated:** June 24, 2022
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Nicole Roberts, OWNER
## Practice location
- **Address:** 1520 E HAMMER LN STE 104, Fort Mohave, AZ 86426-6665
- **Phone:** (602) 315-0211
## Record status
- **NPPES last updated:** June 24, 2022
- **Other identifiers:** Other 23375081 (AZ)
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1356073852) · Data from the CMS NPPES public registry.