Individual provider Active NPI

Nicole Robeson, PHARMACY TECHNICIAN

  • Pharmacy Technician
  • Lewiston, ID
National Provider Identifier
1871356360
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
CT21438 Issued in ID
Practice address
1904 19TH Ave
Lewiston, ID 83501-4069
Phone
(208) 743-9127
Fax
(208) 743-4777
NPI assigned
Feb 6, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X CT21438 ID Primary

Addresses

Primary practice location

1904 19TH Ave
Lewiston, ID 83501-4069

Mailing address

1904 19TH Ave
Lewiston, ID 83501-4069
Phone (208) 743-9127

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CT21438IDMDPharmacy Technician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1707177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1871356360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1904 19TH AVE",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014069",
            "telephone_number": "208-743-9127",
            "fax_number": "208-743-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 19TH AVE",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014069",
            "telephone_number": "208-743-9127",
            "fax_number": "208-743-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBESON",
        "first_name": "NICOLE",
        "credential": "PHARMACY TECHNICIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-06",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "ID",
            "license": "CT21438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.