Provider Demographics
NPI:1073699161
Name:BRYANT, EMILY (ARNP)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:
Last Name:BRYANT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-3468
Mailing Address - Country:US
Mailing Address - Phone:603-785-1224
Mailing Address - Fax:603-410-6682
Practice Address - Street 1:314 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-3468
Practice Address - Country:US
Practice Address - Phone:603-785-1224
Practice Address - Fax:603-410-6682
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH041341-23-08363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30343105Medicaid
NHNP4482Medicare ID - Type Unspecified