BRYAN J EBELING (NPI# 1164058087) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164058087 |
| Entity Type | Individual |
| Full Name | BRYAN J EBELING |
| Practice Address |
1200 N Beaver St Flagstaff AZ 86001-3118 |
| Mailing Address |
7805 W Sweetwater Trl Flagstaff AZ 86001-8191 |
| Practice Telephone | 9287793366 |
| Mailing Telephone | 4357490078 |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2020-03-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
239674 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AANP | F03200300 | 01 |
| Street Address |
1200 N BEAVER ST |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86001-3118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346241189 | Alvin B Elisco | Internal Medicine | 1200 N Beaver St, Fmc Hospitalists, Flagstaff, AZ 86001-3118 | 2005-08-02 |
| 1285240515 | Amika Noel | Nurse Anesthetist, Certified Registered | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-09-22 |
| 1669084190 | Margaret Grace Mcgough | Registered Nurse | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-08-17 |
| 1942818398 | Regan Rowson | Registered Nurse | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-07-21 |
| 1871118984 | Nancy Gloria Flores | Audiologist | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-06-15 |
| 1679100705 | Kristy Anderson | Occupational Therapist | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-03-26 |
| 1447808407 | Bryce Aldworth Randall | Registered Nurse | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2019-09-03 |
| 1851952162 | Samuel Small | Nurse Practitioner | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2019-06-26 |
| 1235797283 | Rebecca R Boger | Dietitian, Registered | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2019-06-04 |
| 1376001321 | Briklin Pierce Arocho | Registered Nurse | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2019-03-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658756 | Marlenne Adair Escobar-mendoza | Specialist/Technologist | 1705 South San Francisco Street, Flagstaff, AZ 86001 | 2020-10-27 |
| 1962033712 | Laura-lee Prescott | Social Worker | Northern Az Va Healthcare System, Flagstaff Cboc, 1300 W. University Ave., Suite 300, Flagstaff, AZ 86001 | 2020-01-30 |
| 1194360784 | Trinity Medical Consultants Pllc | Internal Medicine | 1521 N Cliff Drive, Flagstaff, AZ 86001 | 2019-11-07 |
| 1154849610 | Altacare, LLC | Family Medicine | 2700 S Woodlands Village Blvd Ste 700, Flagstaff, AZ 86001 | 2017-09-05 |
| 1487174926 | Lindsey Marie Forstie | Nurse Practitioner | 7263 E Dreamview Trail, Flagstaff, AZ 86001 | 2017-06-26 |
| 1255860763 | Welbrook Senior Living Flagstaff LLC | Skilled Nursing Facility | 1521 N Pine Cliff Dr, Flagstaff, AZ 86001 | 2017-06-08 |
| 1912432675 | Ryan Tiscareno | Specialist/Technologist | 621 West Cherry Ave, Flagstaff, AZ 86001 | 2017-05-01 |
| 1629432380 | Behavioral Consultation Services, Inc. | Clinic/Center | 345 S. River Run Road, Suite 200, Flagstaff, AZ 86001 | 2016-04-08 |
| 1275920928 | Junli Gallagher | Speech-Language Pathologist | 1215 N. Beaver St, Flagstaff, AZ 86001 | 2015-04-21 |
| 1932592599 | Kristen Flugstad Psyd, LLC | Psychologist | 125 East Elm Avenue #203, Flagstaff, AZ 86001 | 2015-03-06 |
| Find all providers in zip 86001 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225647209 | Ashley Broek Peak | Nurse Practitioner | 2212 N Lantern Ln, Flagstaff, AZ 86001-1133 | 2020-07-27 |
| 1053899583 | Sarah Mcnaughton Preston | Nurse Practitioner | 1424 N Evergreen Dr, Flagstaff, AZ 86001-1416 | 2018-08-06 |
| 1093218877 | Vanessa Margaret Scheu | Nurse Practitioner | 3861 Jemez, Flagstaff, AZ 86005-4061 | 2018-03-17 |
| 1376911925 | Np Fromhome, LLC | Nurse Practitioner | 1016 W. University Ave, Suite 206, Flagstaff, AZ 86011 | 2015-09-11 |
| 1215349741 | Gail Stearley | Nurse Practitioner | 710 N Beaver St Bldg 6, Flagstaff, AZ 86001-3148 | 2014-06-02 |
| 1508287665 | Mountain Healing | Nurse Practitioner | 2323 E Greenlaw Ln Ste 10b, Flagstaff, AZ 86004-1849 | 2013-12-16 |
| 1033557103 | Katie A Lemke | Nurse Practitioner | 1350 N Rim Dr, Flagstaff, AZ 86001-3111 | 2013-06-11 |
| 1548544083 | Megan Engbring | Nurse Practitioner | 1501 S Yale St Ste 152, Flagstaff, AZ 86001-7337 | 2011-10-03 |
| 1033380258 | Dorothy Jean Dunn | Nurse Practitioner | 4772 S Bright Angel Trl, Flagstaff, AZ 86001-8366 | 2008-03-14 |
| 1699961557 | Elise Eastburn | Nurse Practitioner | 809 W Riordan Rd, Ste 100 #273, Flagstaff, AZ 86001-0801 | 2007-09-24 |
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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.