Provider Demographics
NPI:1164106340
Name:BRYANT, MERLYN (HOME HEALTH AID)
Entity Type:Individual
Prefix:MRS
First Name:MERLYN
Middle Name:
Last Name:BRYANT
Suffix:
Gender:F
Credentials:HOME HEALTH AID
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5717 SPLIT OAK LN
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-6737
Mailing Address - Country:US
Mailing Address - Phone:850-350-6766
Mailing Address - Fax:
Practice Address - Street 1:5717 SPLIT OAK LN
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-6737
Practice Address - Country:US
Practice Address - Phone:850-350-6766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide