Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ellen Grace Tebos, FNP-BC

Individual provider Family Nurse Practitioner · NPI 1720626641

Ellen Grace Tebos, FNP-BC is a Nurse Practitioner in Muskegon, Michigan. Qualified in 2019, 7 years ago. Practices with County Line Primary Care, a 10-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
7
Licensed in
MI
In the registry since
2019
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

550 W Western Ave Apt 307
Muskegon, MI 49440-1086
Phone: (616) 914-9657
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 2019047894 (MI)

Record details

NPI number1720626641
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-BC
Sole proprietorNo
NPI enumeratedDecember 11, 2019
Last updated in NPPESDecember 11, 2019
Certification dateDecember 11, 2019

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice County Line Primary Care — 10 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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