Healthcare Provider Details

I. General information

NPI: 1356287023
Provider Name (Legal Business Name): HEIDI MARIE ROBERTUS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 S BELTLINE HWY E
SCOTTSBLUFF NE
69361-3507
US

IV. Provider business mailing address

1620 Q ST
GERING NE
69341-2757
US

V. Phone/Fax

Practice location:
  • Phone: 308-633-1912
  • Fax:
Mailing address:
  • Phone: 308-631-7695
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License NumberV00349405
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: