Healthcare Provider Details

I. General information

NPI: 1487307013
Provider Name (Legal Business Name): INSTANOVA HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2022
Last Update Date: 07/05/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11225 N 28TH DR STE A102-19
PHOENIX AZ
85029-5606
US

IV. Provider business mailing address

PO BOX 6012
PHOENIX AZ
85005-6012
US

V. Phone/Fax

Practice location:
  • Phone: 480-788-0240
  • Fax:
Mailing address:
  • Phone: 480-788-0240
  • Fax: 602-654-6720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NELSON MCNOVA BRYANT
Title or Position: CO-CHAIR/CHIEF OPERATING OFFICER
Credential: PHD, FNP
Phone: 480-788-0240