BRYAN J EBELING


Address: 1200 N Beaver St, Flagstaff, AZ 86001-3118
Phone: 9287793366

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
239674 AZ Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
AANP F03200300 01

Office Location

Street Address 1200 N BEAVER ST
City FLAGSTAFF
State AZ
Zip Code 86001-3118

Providers in the same location

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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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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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Competitor

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City FLAGSTAFF
Zip Code 86001

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Dataset Information

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.

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