Ellina Rose Bastian, is a
Student In An Organized Health Care Education/training Program based in Chino Valley, Arizona. Ellina Rose Bastian is licensed to practice in * (Not Available) (license number ) and her current practice location is
1558 E Yorkshire Ave, Chino Valley, Arizona. She can be reached at her office (for appointments etc.) via phone at
(815) 980-9155.
NPI number for Ellina Rose Bastian is 1679425466 and her current mailing address is 1558 E Yorkshire Ave, Chino Valley, Arizona. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1679425466.
Provider's Profile
| Full Name | Ellina Rose Bastian |
|---|
| Gender | Female |
|---|
| Speciality | Student In An Organized Health Care Education/training Program |
|---|
| Location | 1558 E Yorkshire Ave, Chino Valley, Arizona |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1679425466
- Provider Enumeration Date: 02/12/2026
- Last Update Date: 02/12/2026
Medical Identifiers
Medical identifiers for Ellina Rose Bastian such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1679425466 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ellina Rose Bastian is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ellina Rose Bastian,
1558 E Yorkshire Ave,
Chino Valley, AZ 86323-7147
Ph: () - | Ellina Rose Bastian,
1558 E Yorkshire Ave,
Chino Valley, AZ 86323-7147
Ph: (815) 980-9155 |
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