CONNIE M EBACH (NPI# 1053417493) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053417493 |
| Entity Type | Individual |
| Full Name | CONNIE M EBACH |
| Credential | NP |
| Practice Address |
1058 College Dr New Town ND 58763-9112 |
| Practice Telephone | (701) 627-4750 |
| Practice Fax Number | 7016272809 |
| Mailing Telephone | (701) 627-4750 |
| Mailing Fax Number | 7016272809 |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | R22087 | ND | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 19686 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 222 N 7th St, Bismarck, ND 585014436 | 7013236000 | 7013235709 |
| Street Address |
1058 COLLEGE DR |
| City | NEW TOWN |
| State | ND |
| Zip Code | 58763-9112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043212749 | Samuel Stuart Johnson | Family Medicine | 1058 College Dr, New Town, ND 58763-9112 | 2005-08-12 |
| 1124641105 | Xaviera Pascale Nyandjo | Pharmacist | 1058 College Dr, New Town, ND 58763-9112 | 2020-05-25 |
| 1720600927 | Gwendolyn Ashley Davis | Registered Nurse | 1058 College Dr, New Town, ND 58763-9112 | 2020-05-11 |
| 1407493216 | Lenaya Marie Martin | Nurse Practitioner | 1058 College Dr, New Town, ND 58763-9112 | 2019-11-30 |
| 1558918045 | Sadie Jayne Dale | Physical Therapist | 1058 College Dr, New Town, ND 58763-9112 | 2019-08-20 |
| 1326501826 | Gregory L Fondong | Pharmacist | 1058 College Dr, New Town, ND 58763-9112 | 2019-04-11 |
| 1659845907 | Jennifer Jordan | Radiology | 1058 College Dr, New Town, ND 58763-9112 | 2019-01-18 |
| 1689146201 | Jared Eagle | Health Educator | 1058 College Dr, New Town, ND 58763-9112 | 2018-12-20 |
| 1164991881 | Shelby Stein | Dietitian, Registered | 1058 College Dr, New Town, ND 58763-9112 | 2018-11-26 |
| 1124511415 | Douglas Mai | Radiology | 1058 College Dr, New Town, ND 58763-9112 | 2018-06-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104332337 | Opportunity Foundation Inc | Day Training, Developmentally Disabled Services | 709 E Eagel Dr, New Town, ND 58763 | 2017-12-26 |
| 1225437460 | New Town Health Support Corporation | Assisted Living Facility | 603 1st Street Nw, New Town, ND 58763 | 2014-08-13 |
| 1992099477 | Debbie Joyce Jeanotte | Registered Nurse | 1 Minne-tohe Drive, Minne-tohe Health Center, New Town, ND 58763 | 2011-06-02 |
| 1831365519 | Elbowoods Memorial Health Center | Clinic/Center | 1058 College Drive, New Town, ND 58763 | 2008-05-02 |
| 1467622704 | Tri City Cares, Inc. | PACE Provider Organization | 709 E Eagle Dr, New Town, ND 58763 | 2008-03-03 |
| 1417028978 | Nora M Rasmussen | Nurse Practitioner | 604 1st St N, New Town, ND 58763 | 2006-11-13 |
| 1194249417 | Cianna Marie Rabbithead | Counselor | 1058 College Drive, New Town, ND 58763 | 2017-07-28 |
| 1619423308 | Ty Thompson | Counselor | 304 7th St N, New Town, ND 58763 | 2016-09-01 |
| 1508051483 | Traci Weaver | Pharmacy Technician | 334 Main Street, New Town, ND 58763 | 2007-09-13 |
| 1467527820 | Cheryl D Ulven | Physician Assistant | 604 1st St N, New Town, ND 58763 | 2006-11-21 |
| Find all providers in zip 58763 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457425845 | Jill M Trulson | Nurse Practitioner | 604 1st St. N, New Town, ND 58763-1029 | 2006-11-20 |
| 1417028978 | Nora M Rasmussen | Nurse Practitioner | 604 1st St N, New Town, ND 58763 | 2006-11-13 |
| 1073974465 | Elbowoods Memorial Health Center | Nurse Practitioner | 1058 College Dr, New Town, ND 58763-9112 | 2016-03-11 |
| 1629283239 | Rosemary J Turner | Nurse Practitioner | 1058 College Dr, Elbowoods Memorial Health Center, New Town, ND 58763-9112 | 2007-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992304695 | Transitions Healthcare Pllc Dba Transitions Healthcare | Nurse Practitioner | 7500 Sentinel St, Bismarck, ND 58504-9615 | 2020-10-22 |
| 1922640507 | Mandy Jo Haug | Nurse Practitioner | 3280 6th St E, West Fargo, ND 58078-5459 | 2019-10-15 |
| 1730741992 | Alicia Michelle Crosby | Nurse Practitioner | 101 3rd Ave Sw Ste 201, Minot, ND 58701-3880 | 2019-07-08 |
| 1871154211 | Chelsea Vollmer | Nurse Practitioner | 4535 Northern Sky Dr Ste 1, Bismarck, ND 58503-8539 | 2019-06-26 |
| 1700446192 | Mckinzie Marie Nuss | Nurse Practitioner | 3201 Rutland Dr, Bismarck, ND 58504-7602 | 2019-06-18 |
| 1003472317 | Sadie Marie Nelson | Nurse Practitioner | Sanford Broadway Clinic, 801 North Broadway, Fargo, ND 58102 | 2019-05-13 |
| 1326602897 | Madison Huff | Nurse Practitioner | 13 2nd Ave Se, Minot, ND 58701-3906 | 2019-04-30 |
| 1801357116 | Ashlyn Marie Deachin | Nurse Practitioner | 106 Indian Rock Cir Apt 1, Minot Afb, ND 58704-1159 | 2019-03-28 |
| 1497224224 | Cimberly Faye Berg | Nurse Practitioner | 310 2nd Ave East, Westhope, ND 58793-4033 | 2018-11-22 |
| 1740769595 | The Evangelical Lutheran Good Samaritan Society | Nurse Practitioner | 301 S Highway 12b, Park River, ND 58270 | 2018-08-13 |
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| 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.