Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Bevin Lyle Ellenberg, CRNP

Individual provider Nurse Practitioner · NPI 1780100776

Bevin Lyle Ellenberg, CRNP is a Nurse Practitioner in Jasper, Alabama. Qualified in 2016, 10 years ago. Practices with Oncology Specialties, PC, a 106-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Alabama.

Years since qualifying
10
Licensed in
AL
In the registry since
2017
What do these letters mean?
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.

See every abbreviation used in this directory →

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Practice location Address checks out

3500 Highway 78 E Ste A
Jasper, AL 35501-8908
Phone: (205) 387-0333
Fax: (256) 534-2605
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 1-140234 (AL)

Record details

NPI number1780100776
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNP
Sole proprietorNo
NPI enumeratedAugust 21, 2017
Last updated in NPPESJune 15, 2026
Certification dateJune 15, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Oncology Specialties, P.C. — 106 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

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