Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Robert Didericksen, PMHNP-BC

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1407231244

Robert Didericksen, PMHNP-BC is a Nurse Practitioner in Eugene, Oregon. Qualified in 2019, 7 years ago. Practices with Center for Family Development, Inc, a 17-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Colorado.

Years since qualifying
7
Licensed in
CO
In the registry since
2015
What do these letters mean?
PMHNP-BC — Psychiatric-Mental Health Nurse Practitioner, Board Certified
A board-certified psychiatric nurse practitioner.

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Practice location Address checks out

1501 Pearl St
Eugene, OR 97401-4010
Phone: (541) 342-8437
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 0995173 (CO)

Record details

NPI number1407231244
Entity typeIndividual (Type 1)
GenderMale
Credentials PMHNP-BC
Sole proprietorNo
NPI enumeratedJuly 22, 2015
Last updated in NPPESNovember 4, 2021
Certification dateFebruary 7, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Center For Family Development, Inc. — 17 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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