MR. ROBERT FRANCIS LIDESTRI (NPI# 1952334427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952334427 |
| Entity Type | Individual |
| Full Name | MR. ROBERT FRANCIS LIDESTRI |
| Credential | NP |
| Practice Address |
3019 Coit Ave Ne Grand Rapids MI 49505-3376 |
| Mailing Address |
351 Arthur St Marne MI 49435-8730 |
| Practice Telephone | 6163659575 |
| Practice Fax Number | 6163659480 |
| Mailing Telephone | 6166773200 |
| Mailing Fax Number | 6166773200 |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
4704158200 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3019 COIT AVE NE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49505-3376 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700830684 | Erik Kooyer | Internal Medicine | 3019 Coit Ave Ne, Grand Rapids, MI 49505-3376 | 2006-05-22 |
| 1508262304 | Scott Michael Kass | Optometrist | 3019 Coit Ave Ne, Grand Rapids, MI 49505-3376 | 2014-11-06 |
| 1821419045 | Sarah Mallis | Psychologist | 3019 Coit Ave Ne, Grand Rapids, MI 49505-3376 | 2013-12-16 |
| 1033467212 | Nicholas James Liimatta | Audiologist | 3019 Coit Ave Ne, Grand Rapids, MI 49505-3376 | 2012-08-21 |
| 1952658767 | Amy Beth Vanderlugt | Dental Hygienist | 3019 Coit Ave Ne, Grand Rapids, MI 49505-3376 | 2012-08-10 |
| 1023313640 | Susan L Clark | Physical Therapy Assistant | 3019 Coit Ave Ne, Grand Rapids, MI 49505-3376 | 2011-01-12 |
| 1235434952 | Amy Marie Easey | Physical Therapy Assistant | 3019 Coit Ave Ne, Grand Rapids, MI 49505-3376 | 2011-01-12 |
| 1649595158 | Janis Kay French | Pharmacist | 3019 Coit Ave Ne, Grand Rapids, MI 49505-3376 | 2010-03-29 |
| 1356665798 | Reynaldo Soto | Physical Therapy Assistant | 3019 Coit Ave Ne, Grand Rapids, MI 49505-3376 | 2010-03-14 |
| 1679802029 | Ryan J Brown | Optometrist | 3019 Coit Ave Ne, Grand Rapids, MI 49505-3376 | 2009-12-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285276097 | Molly Beth Kerkstra | Home Health Aide | 1115 Ball Ave Nw, Grand Rapids, MI 49505 | 2019-10-14 |
| 1154849677 | Roshawn Nichol Whitley | Technician | 891 Maryland Ave, Grand Rapids, MI 49505 | 2017-09-05 |
| 1447778923 | Kelly Benzin-brinks | Social Worker | 1965 3 Mile Rd Ne, Grand Rapids, MI 49505 | 2017-09-05 |
| 1033560404 | Taylor Nolan Boyd | Speech-Language Pathologist | 400 Ann St Ne Ste 106a, Grand Rapids, MI 49505 | 2016-06-28 |
| 1023465002 | Calvin Athy | Counselor | 1101 Ballave Ne, Grand Rapids, MI 49505 | 2016-05-19 |
| 1821456682 | Kelly Van Huisen | Counselor | 1115 Ball Avenue Ne, Building B, Grand Rapids, MI 49505 | 2016-02-08 |
| 1780051102 | Mark Squeteri | Social Worker | 1345 Monroe Ave Nw Ste 234, Grand Rapids, MI 49505 | 2015-09-02 |
| 1346637337 | Shelby Fullington | Social Worker | 1011 Ball Ave Ne, Grand Rapids, MI 49505 | 2015-04-17 |
| 1457745325 | Lester Anderson II | Social Worker | 1115 Ball Ave, Grand Rapids, MI 49505 | 2015-03-27 |
| 1730570151 | Nicole Brown | Counselor | 1345 Monroe Ave Nw Ste 204, Grand Rapids, MI 49505 | 2015-02-06 |
| Find all providers in zip 49505 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457753295 | Tracy Zimmerman-deschepper | Nurse Practitioner | 28 Nw 4th Street, Suite A, Grand Rapids, MN 55744-2714 | 2014-09-24 |
| 1538576517 | Kari Marie Rengo | Nurse Practitioner | 28 Nw 4th St, Ste A, Grand Rapids, MN 55744-2714 | 2014-07-22 |
| 1205163680 | Lisa Ann Riggs | Nurse Practitioner | 1619 Mishawaka Rd, Grand Rapids, MN 55744-8709 | 2009-11-05 |
| 1336789916 | Rhea Lou Valdez Del Rosario | Nurse Practitioner | 20 Nw 3rd St, Grand Rapids, MN 55744-2711 | 2020-01-10 |
| 1669025888 | Rachel Owen | Nurse Practitioner | 100 Cherry St Se, Grand Rapids, MI 49503-4526 | 2019-07-17 |
| 1538649223 | Dannielle Chantel Chesness Nelson | Nurse Practitioner | 215 Se 2nd Ave, Grand Rapids, MN 55744-3615 | 2018-08-21 |
| 1154861565 | Karli Reich | Nurse Practitioner | 1055 Medical Park Dr Se, Grand Rapids, MI 49546-3607 | 2017-03-03 |
| 1437522711 | Lisa Riggs Aprn Cnp LLC | Nurse Practitioner | 423 Ne 4th St, Suite 6, Grand Rapids, MN 55744-2968 | 2015-11-09 |
| 1124494539 | Amy Catherine Stratton | Nurse Practitioner | 1055 Medical Park Dr Se, Grand Rapids, MI 49546-3607 | 2015-08-19 |
| 1578948428 | Krista L Alaspa | Nurse Practitioner | 215 Se 2nd Ave, Grand Rapids, MN 55744-3615 | 2015-07-21 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49505 |
Please comment or provide details below to improve the information on MR. ROBERT FRANCIS LIDESTRI.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.