MEDICARE: BRYNN ELIZABETH EIXENBERGER REGISTERED NURSE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN60225499	WA

General Provider Information

NPI Number	:	1184194268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRYNN ELIZABETH EIXENBERGER REGISTERED NURSE

Provider Business Mailing Address
First Line	:	611 N IRON BRIDGE WAY
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99202-4932
Country	:	US
Telephone Number	:	509-444-8888
Fax Number	:

Provider Business Practice Location Address
First Line	:	1313 N ATLANTIC ST
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99201-2303
Country	:	US
Telephone Number	:	509-444-8200
Fax Number	:	509-434-0392

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2018
Last Update Date	:	01/19/2023

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