Malisa Bryan

Student in an Organized Health Care Education/Training Program in Idaho Falls, ID. Individual provider (NPI-1).

NPI number1659068351

StatusActive

Last updated in NPPESMar 18, 2024

Details

NPI: 1659068351
Entity type: Individual (NPI-1)
Name: Malisa Bryan
Sex: Female
Sole proprietor: No
Enumeration date: Apr 21, 2023
Certification date: Mar 18, 2024
Last updated: Mar 18, 2024

Medicare and OIG

Medicare enrolled (PECOS): Yes · ORDER AND REFERRING ONLY - INTERNAL MEDICINE
Can order and refer: Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
390200000X	Student in an Organized Health Care Education/Training Program	–	–	Yes

Practice location

3100 Channing Way
Idaho Falls, ID 83404-7533

Phone 208-227-2850

Mailing address

3100 Channing Way
Idaho Falls, ID 83404-7533

Phone 208-227-2850

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Student in an Organized Health Care Education/Training Program providers in Idaho Falls, ID

All 63 Student in an Organized Health Care Education/Training Program providers in Idaho Falls · All 3,646 providers in Idaho Falls

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