Provider Demographics
NPI:1235239948
Name:BRYANT, ANN (RD)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:
Last Name:BRYANT
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:BROOKS
Other - Last Name:BRYANT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD
Mailing Address - Street 1:13020 CRABAPPLE PL
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72210-6908
Mailing Address - Country:US
Mailing Address - Phone:501-455-0872
Mailing Address - Fax:
Practice Address - Street 1:2200 FORT ROOTS DR
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72114-1709
Practice Address - Country:US
Practice Address - Phone:501-257-2880
Practice Address - Fax:501-257-2879
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
378193133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered