Provider Demographics
NPI:1205395282
Name:BRYANT, PERI KATHRYN (FNP- C)
Entity Type:Individual
Prefix:
First Name:PERI
Middle Name:KATHRYN
Last Name:BRYANT
Suffix:
Gender:F
Credentials:FNP- C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 HOLMES DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:AL
Mailing Address - Zip Code:36203-2420
Mailing Address - Country:US
Mailing Address - Phone:256-448-3578
Mailing Address - Fax:
Practice Address - Street 1:30 HOLMES DR
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:AL
Practice Address - Zip Code:36203-2420
Practice Address - Country:US
Practice Address - Phone:256-448-3578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-152036363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner