BRAIDEN CLARK FAIRBANKS
Student in an Organized Health Care Education/Training Program

Address: 435 N 5th St, Phoenix, AZ 85004-2157

BRAIDEN CLARK FAIRBANKS (NPI# 1164017679) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1164017679
Entity Type Individual
Full Name BRAIDEN CLARK FAIRBANKS
Gender Male
Practice Address 435 N 5th St
Phoenix
AZ 85004-2157
Practice Telephone 6028272450
Mailing Address 5302 E Van Buren St Unit 3021
Phoenix
AZ 85008-7975
Mailing Telephone 4807211784
Certification Date 2021-03-05
Enumeration Date 2021-03-05
Last Update Date 2021-03-05
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification Group License Number License State Taxonomy Group
Y 390200000X Student in an Organized Health Care Education/Training Program Student, Health Care

Office Location

Street Address 435 N 5TH ST
City PHOENIX
State AZ
Zip Code 85004-2157

Providers in the same location

NPI Name Taxonomy Address Enumeration
1073108585 Morgan Elexis Sloan Student in an Organized Health Care Education/Training Program 435 N 5th St, Phoenix, AZ 85004-2157 2021-03-05
1073108593 Javier Omar Yepiz Student in an Organized Health Care Education/Training Program 435 N 5th St, Phoenix, AZ 85004-2157 2021-03-05
1154916674 Alan Gonzalez Student in an Organized Health Care Education/Training Program 435 N 5th St, Phoenix, AZ 85004-2157 2021-03-05
1164017687 Denise Alisha Lalio Student in an Organized Health Care Education/Training Program 435 N 5th St, Phoenix, AZ 85004-2157 2021-03-05
1184219693 Reena Marie Ygot Student in an Organized Health Care Education/Training Program 435 N 5th St, Phoenix, AZ 85004-2157 2021-03-05
1245825769 Allison Olshove Physician Assistant 435 N 5th St, Phoenix, AZ 85004-2157 2021-03-05
1265027775 Amy Marie Carney Student in an Organized Health Care Education/Training Program 435 N 5th St, Phoenix, AZ 85004-2157 2021-03-05
1275128787 Patrick Lam Student in an Organized Health Care Education/Training Program 435 N 5th St, Phoenix, AZ 85004-2157 2021-03-05
1366037871 Rebecca Rose Flores Student in an Organized Health Care Education/Training Program 435 N 5th St, Phoenix, AZ 85004-2157 2021-03-05
1457946964 Pawanvir Singh Tung Student in an Organized Health Care Education/Training Program 435 N 5th St, Phoenix, AZ 85004-2157 2021-03-05
Find all providers in the same address

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1528682853 Tyler Gallo Pharmacist 475 N 5th St, Phoenix, AZ 85004-2157 2020-06-02
1720541154 Dalan Brown Student in an Organized Health Care Education/Training Program 475 N 5th St, Phoenix, AZ 85004-2157 2019-04-11
1275913642 Ashion Analytics, LLC Clinical Medical Laboratory 445 N 5th St, Phoenix, AZ 85004-2157 2015-06-01
1275911620 Scott Howard Conant Orthopaedic Surgery 475 N 5th St, Phoenix, AZ 85004-2157 2015-05-18
1477898583 Paradigm Diagnostics Inc Pathology · Cytopathology 445 N 5th St, 300, Phoenix, AZ 85004-2157 2012-11-29

Providers in the same zip code prefix

NPI Name Taxonomy Address Enumeration
1396360749 Ulivvo Inc. Nurse Practitioner · Family 141 E Palm Lane, Suite 206, Phoenix, AZ 85004 2020-06-11
1366003139 Smiths Food & Drug Centers Inc Durable Medical Equipment & Medical Supplies 100 E Jefferson St, Phoenix, AZ 85004 2019-06-24
1508325929 Ican America Clinic/Center · Multi-Specialty Cityscape Tower 1 E Washington St., Suite 440, Phoenix, AZ 85004 2019-03-15
1770064107 Edward Jude Stein Pharmacist Two Renaissance Square, 40 N Central Ave, Suite 780, Ihs Clinical Support Center, Phoenix, AZ 85004 2018-08-23
1740775303 Alexander L. Shaw Dentist · General Practice 201 N Central Ave. #1490, Phoenix, AZ 85004 2018-06-26
1922505908 Munachiso Iheonunekwu Nurse Practitioner · Psychiatric/Mental Health 2715 N 3rd St, Phoenix, AZ 85004 2018-04-06
1497267868 Michael Dimoff Registered Nurse 1850 N. Central Ave, Ste 1600, Phoenix, AZ 85004 2017-10-25
1093231433 Ezequiel Bautista Music Therapist 2702 N 3rd Street, Suite 1000, Phoenix, AZ 85004 2017-08-17
1841742442 Stacy Maahs Nurse Practitioner · Family 500 N 3rd St Ste 155, Phoenix, AZ 85004 2016-10-29
1073061073 Kristin Neal Husain Nurse Anesthetist, Certified Registered 1850 N Central Ave, Ste 1600, Phoenix, AZ 85004 2016-09-19
Find all providers in zip 85004

Taxonomy Information

Taxonomy Code 390200000X
Grouping Student, Health Care
Classification Student in an Organized Health Care Education/Training Program

Taxonomy Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Notes: [1/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1396330825 Martin Tai Nguyen 5824 N 21st Ave, Phoenix, AZ 85015-2341 2021-03-06
1740875251 Tiffany Denise Bradley 2517 W Apollo Rd, Phoenix, AZ 85041-5338 2021-03-05
1760077275 Melissa Marie Aswad 699 W Georgia Ave, Phoenix, AZ 85013-2020 2021-03-05
1992390405 Marco Antonio Enriquez 1012 E Mitchell Dr, Phoenix, AZ 85014-5211 2021-03-05
1003401514 Brittany Barbarisi 1313 N 2nd St Apt 1213, Phoenix, AZ 85004-1766 2021-03-05
1649865155 Sydney Paige Polychronis 5235 W Desert Hollow Dr, Phoenix, AZ 85083-4405 2021-03-05
1679168181 Brooke Ann Robinson 1333 E Morten Ave Unit 137, Phoenix, AZ 85020-4559 2021-03-05
1659966166 Kaelyn Garner 1616 N Central Ave Apt 1314, Phoenix, AZ 85004-1658 2021-03-05
1730774241 Andrew Tkacik 1616 N Central Ave Apt 1432, Phoenix, AZ 85004-1661 2021-03-05
1629663133 Oscar Orlando Campuzano Jr. 2220 E Beardsley Rd Apt 1127, Phoenix, AZ 85024-3412 2021-03-05
Find all providers in PHOENIX

Competitor

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City PHOENIX
Zip Code 85004

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Dataset Information

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.