Provider Demographics
NPI:1093236853
Name:ECKHARD, BRYAN (FNP-C)
Entity Type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:
Last Name:ECKHARD
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 WARD RD STE 110
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-1819
Mailing Address - Country:US
Mailing Address - Phone:720-727-2690
Mailing Address - Fax:720-727-2691
Practice Address - Street 1:5400 WARD RD STE 110
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-1819
Practice Address - Country:US
Practice Address - Phone:720-727-2690
Practice Address - Fax:720-727-2691
Is Sole Proprietor?:No
Enumeration Date:2017-07-02
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017022712363LF0000X, 363LP0808X
COC-APN.0001980-C-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily