Provider Demographics
NPI:1023861481
Name:BIEDENBACH, ERIC CHARLES (PMHNP-BC)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:CHARLES
Last Name:BIEDENBACH
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13640 N PLAZA DEL RIO BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4846
Mailing Address - Country:US
Mailing Address - Phone:623-876-8420
Mailing Address - Fax:
Practice Address - Street 1:13640 N PLAZA DEL RIO BLVD FL 2
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4846
Practice Address - Country:US
Practice Address - Phone:623-876-8420
Practice Address - Fax:623-285-2626
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ300543363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health