Provider Demographics
NPI:1235276304
Name:BRYANT, HILDA PATRICIA (PA-C)
Entity Type:Individual
Prefix:
First Name:HILDA
Middle Name:PATRICIA
Last Name:BRYANT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 KINGS LANE
Mailing Address - Street 2:P.O. BOX 695
Mailing Address - City:TULLAHOMA
Mailing Address - State:TN
Mailing Address - Zip Code:37388-5372
Mailing Address - Country:US
Mailing Address - Phone:931-454-9411
Mailing Address - Fax:931-454-2145
Practice Address - Street 1:715 KINGS LANE
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-5372
Practice Address - Country:US
Practice Address - Phone:931-454-9411
Practice Address - Fax:931-454-2145
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA0000000925363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant