Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 3003971 | KY |
NPI | 1033143573 |
---|---|
Provider Name | Jamie S Bryant |
First Address | Louisville, KY 40241-2091 |
Second Address | Louisville, KY 40241-2091 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 23/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200869410 | (05) | IN |
78013372 | (05) | KY |
P92286 | (02) |