Provider Demographics
NPI:1679465892
Name:EBBING, ELEANOR (APRN, MSN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ELEANOR
Middle Name:
Last Name:EBBING
Suffix:
Gender:F
Credentials:APRN, MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14409 N 45TH AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-4515
Mailing Address - Country:US
Mailing Address - Phone:319-601-1814
Mailing Address - Fax:
Practice Address - Street 1:14409 N 45TH AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4515
Practice Address - Country:US
Practice Address - Phone:319-601-1814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ326389363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health