Provider Demographics
NPI:1124905674
Name:MARSH, BRYAN DANIEL (RN)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:DANIEL
Last Name:MARSH
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55930 BLUE EAGLE RD
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97707-2369
Mailing Address - Country:US
Mailing Address - Phone:541-640-2166
Mailing Address - Fax:
Practice Address - Street 1:55930 BLUE EAGLE RD
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97707-2369
Practice Address - Country:US
Practice Address - Phone:541-640-2166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201242209RN163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health