Healthcare Provider Details

I. General information

NPI: 1508725805
Provider Name (Legal Business Name): KIRK ROBBINS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/21/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1008 HOMESTEAD DR
EMMETT ID
83617-5049
US

IV. Provider business mailing address

1008 HOMESTEAD DR
EMMETT ID
83617-5049
US

V. Phone/Fax

Practice location:
  • Phone: 406-839-6050
  • Fax:
Mailing address:
  • Phone: 406-839-6050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0812X
TaxonomyCommunity Psychiatric/Mental Health Clinical Nurse Specialist
License Number74728
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: