Healthcare Provider Details

I. General information

NPI: 1053160234
Provider Name (Legal Business Name): BRYNN ECKLUND PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRYNN CARLSON

II. Dates (important events)

Enumeration Date: 05/18/2024
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56720 CALUMET AVE
CALUMET MI
49913-1904
US

IV. Provider business mailing address

301 EXPLORER ST
GWINN MI
49841-2813
US

V. Phone/Fax

Practice location:
  • Phone: 906-483-1177
  • Fax: 906-372-3230
Mailing address:
  • Phone: 906-483-1130
  • Fax: 906-483-1394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704353139
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: