Provider Demographics
NPI:1093236853
Name:ECKHARD, BRYAN (FNP-C, PMHNP-BC)
Entity type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:
Last Name:ECKHARD
Suffix:
Gender:M
Credentials:FNP-C, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 CLAYTON ST
Mailing Address - Street 2:
Mailing Address - City:BRUSH
Mailing Address - State:CO
Mailing Address - Zip Code:80723-2104
Mailing Address - Country:US
Mailing Address - Phone:720-734-2867
Mailing Address - Fax:720-912-8307
Practice Address - Street 1:206 CLAYTON ST
Practice Address - Street 2:
Practice Address - City:BRUSH
Practice Address - State:CO
Practice Address - Zip Code:80723-2104
Practice Address - Country:US
Practice Address - Phone:720-734-2867
Practice Address - Fax:720-912-8307
Is Sole Proprietor?:No
Enumeration Date:2017-07-02
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0996445-NP363LF0000X, 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