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

Jacob Russell Bryde, DNP, AGPCNP-BC

Individual provider Gerontology Nurse Practitioner · NPI 1821836024

Jacob Russell Bryde, DNP, AGPCNP-BC is a Nurse Practitioner in East Lansing, Michigan. Qualified in 2024, 2 years ago. Practices with Powerback Rehabilitation LLC, a 616-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Michigan.

Years since qualifying
2
Licensed in
MI
In the registry since
2024
What do these letters mean?
DNP — Doctor of Nursing Practice
The highest clinical degree in nursing.

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Practice location Address checks out

804 Service Rd Ste A110
East Lansing, MI 48824-7015
Phone: (517) 353-2822
Fax: (517) 355-2824
Show map & directions

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

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence 4704335991 (MI)

Record details

NPI number1821836024
Entity typeIndividual (Type 1)
GenderMale
Credentials DNP , AGPCNP-BC
Sole proprietorNo
NPI enumeratedJuly 20, 2024
Last updated in NPPESOctober 15, 2024
Certification dateOctober 15, 2024

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Powerback Rehabilitation Llc — 616 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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