Bevin Lyle Ellenberg, CRNP

Nurse Practitioner · Jasper, AL

Individual Active NPI

NPI number 1780100776

Practice location

3500 Highway 78 E Ste a
Jasper, AL 35501-8908
Phone
(205) 387-0333
Fax
(256) 534-2605

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NPI record

NPI
1780100776
Entity type
Individual (Type 1)
Enumeration date
August 21, 2017
Last updated
June 15, 2026
Certified
June 15, 2026
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Nurse Practitioner Primary 363L00000X 1-140234 AL

Mailing address

PO Box 18428
Huntsville, AL 35804-8428
Phone
(256) 705-4224
Fax
(256) 705-4135

About Bevin Ellenberg

Bevin Lyle Ellenberg, CRNP is a healthcare provider registered in the NPI registry with the primary taxonomy Nurse Practitioner (code 363L00000X). The practice location is 3500 Highway 78 E Ste a, Jasper, AL 35501-8908. The NPI number 1780100776 was assigned on August 21, 2017 and the record was last updated on June 15, 2026.

Bevin Ellenberg lists a license in the registry: #1-140234 (AL) for Nurse Practitioner. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Bevin Lyle Ellenberg, CRNP?

The NPI number is 1780100776.

What is the phone number of Bevin Ellenberg?

The phone number listed for the practice location is (205) 387-0333.

Where is Bevin Ellenberg located?

3500 Highway 78 E Ste a, Jasper, AL 35501-8908.

What is the taxonomy code for Bevin Ellenberg?

The primary taxonomy code is 363L00000X – Nurse Practitioner.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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