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

Edward Shane Trantham, FNP-C

Individual provider Family Nurse Practitioner · NPI 1043780349

Edward Shane Trantham, FNP-C is a Nurse Practitioner in Holbrook, Arizona. Qualified in 2018, 8 years ago. Accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
8
Licensed in
AZ
In the registry since
2018
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

2109 Navajo Blvd
Holbrook, AZ 86025-1822
Phone: (928) 524-2851
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 219546 (AZ)

Record details

NPI number1043780349
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedNovember 29, 2018
Last updated in NPPESMarch 19, 2021
Certification dateMarch 19, 2021
Mailing addressPo Box 3630, Flagstaff, AZ 86003-3630

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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