DR. IDELLA MARIE BRYANT (NPI# 1760697510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760697510 |
| Entity Type | Individual |
| Full Name | DR. IDELLA MARIE BRYANT |
| Credential | PHARMD |
| Practice Address |
167 N Main Street Tuba City AZ 86045-0600 |
| Mailing Address |
Po Box 600 Tuba City AZ 86045-0600 |
| Practice Telephone | 9282832754 |
| Practice Fax Number | 9282832758 |
| Mailing Telephone | 9282832754 |
| Mailing Fax Number | 9282832758 |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 14773 | AZ | Pharmacy Service Providers |
| Street Address |
167 N MAIN STREET |
| City | TUBA CITY |
| State | AZ |
| Zip Code | 86045-0600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801878657 | Kaitlyn M Solola | Pharmacist | 167 N Main Street, Tuba City, AZ 86045-0600 | 2005-11-17 |
| 1780209031 | Gloriana R Woodie | Counselor | 167 N Main Street, Tuba City, AZ 86045 | 2020-06-12 |
| 1528536026 | Hope Fonbah | Pharmacist | 167 N Main Street, Tuba City, AZ 86045 | 2018-11-02 |
| 1689150674 | Kelsey Sterk | Optometrist | 167 N Main Street, Tuba City, AZ 86045 | 2018-07-13 |
| 1992292486 | Joe Collucci | Radiologic Technologist | 167 N Main Street, Tuba City, AZ 86045-0600 | 2018-04-19 |
| 1811484306 | Shyanne Lomayaktewa | Radiologic Technologist | 167 N Main Street, Tuba City, AZ 86045-0600 | 2018-04-19 |
| 1235626714 | Pearlena Beyal | Radiologic Technologist | 167 N Main Street, Tuba City, AZ 86045-0600 | 2018-04-19 |
| 1245727734 | Lynelle Zahne | Radiologic Technologist | 167 N Main Street, Tuba City, AZ 86045-0600 | 2018-04-19 |
| 1285140319 | Valencia Elva Ketchum | Nurse's Aide | 167 N Main Street, Po Box 600, Tuba City, AZ 86045-0600 | 2017-12-27 |
| 1851807788 | Andew Williamson | Registered Nurse | 167 N Main Street, Po Box 600, Tuba City, AZ 86045-0600 | 2017-12-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205434206 | Ambrielle Grace Begay | Specialist/Technologist | 48 Turquoise Drive, Tuba City, AZ 86045 | 2020-10-12 |
| 1063028124 | Fresenius Medical Care Tuba City, LLC | Clinic/Center | 50 S. Main Street, Ste 108, Tuba City, AZ 86045 | 2020-09-23 |
| 1609422484 | Rebekah Lee | Pharmacist | 167 North Main St. Tuba City Regional Health Care Corp., Tuba City, AZ 86045 | 2019-08-16 |
| 1861977050 | Kyle C Nguyen | Pharmacist | 3008 E. Birch Ave, Tuba City, AZ 86045 | 2018-10-03 |
| 1518419845 | John Glenn Ives | Pharmacist | 167 N, Main St, Tuba City, AZ 86045 | 2016-11-03 |
| 1497208433 | Toweringrock Non-emergency Medical Transport, LLC | Non-emergency Medical Transport (VAN) | 1029 E. Tc North Side Trailer, 36.153821-111.233925, Tuba City, AZ 86045 | 2016-07-26 |
| 1699153270 | Hopi Assisted Living Facility Inc. | Point of Service | 21 Senior Lane Upper Hud Housing Moenkopi, Hopi Assisted Living, Tuba City, AZ 86045 | 2015-05-14 |
| 1306223870 | Mia Seimy | Driver | Adair Avenue Space #5, Tuba City, AZ 86045 | 2015-05-04 |
| 1033507587 | Tari Carroll | Home Health Aide | Tumbleweed Drive Nha E-3, Tuba City, AZ 86045 | 2015-01-07 |
| 1023452984 | Amanda Bancroft Burrage | Pediatrics | 167 Main St., Tuba City, AZ 86045 | 2013-04-23 |
| Find all providers in zip 86045 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609422484 | Rebekah Lee | Pharmacist | 167 North Main St. Tuba City Regional Health Care Corp., Tuba City, AZ 86045 | 2019-08-16 |
| 1861977050 | Kyle C Nguyen | Pharmacist | 3008 E. Birch Ave, Tuba City, AZ 86045 | 2018-10-03 |
| 1699298257 | Austin Vanhorn | Pharmacist | Po Box 600, Tuba City, AZ 86045-0600 | 2017-07-25 |
| 1518419845 | John Glenn Ives | Pharmacist | 167 N, Main St, Tuba City, AZ 86045 | 2016-11-03 |
| 1851695597 | Andrea E Morales | Pharmacist | 1016a Tamarax, Tuba City, AZ 86045 | 2011-01-10 |
| 1851691257 | Daniel Joseph Deering | Pharmacist | 167 N. 167, Tuba City, AZ 86045-6318 | 2010-11-01 |
| 1659559557 | Eugene Robert Wagner | Pharmacist | 169 N Main, Tuba City Regional Healthcare Corporation, Tuba City, AZ 86045 | 2008-02-04 |
| 1962618181 | Scott Allen Thompson | Pharmacist | 167 N Main, Tuba City, AZ 86045 | 2007-05-15 |
| 1235351701 | Reasol Agustin Chino | Pharmacist | 167 East Main St, Tuba City, AZ 86045-0600 | 2007-05-03 |
| 1306974084 | Denise T Vermilyea | Pharmacist | 169 N. Main St, Tuba City, AZ 86045 | 2007-03-02 |
| Find all providers in TUBA CITY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.