Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ebenezer Bodude, RN

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1275900060

Ebenezer Bodude, RN is a Nurse Practitioner in Phoenix, Arizona. Qualified in 2023, 3 years ago. Practices with Community Bridges Inc, a 107-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Arizona.

Years since qualifying
3
Licensed in
AZ
In the registry since
2015
What do these letters mean?
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.

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Practice location Address checks out

11225 N 28th Dr
Phoenix, AZ 85029-5606
Phone: (602) 699-6999
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 298440 (AZ)

Record details

NPI number1275900060
Entity typeIndividual (Type 1)
GenderMale
Credentials RN
Sole proprietorYes
NPI enumeratedAugust 27, 2015
Last updated in NPPESOctober 25, 2023
Certification dateOctober 4, 2023

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Community Bridges Inc — 107 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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