Provider Demographics
NPI:1164201018
Name:BRYANT, ALDINE N
Entity Type:Individual
Prefix:
First Name:ALDINE
Middle Name:N
Last Name:BRYANT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1953 DENTON ST APT C
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-5452
Mailing Address - Country:US
Mailing Address - Phone:202-394-4579
Mailing Address - Fax:
Practice Address - Street 1:1953 DENTON ST APT C
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-5452
Practice Address - Country:US
Practice Address - Phone:202-394-4579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide