Provider Demographics
NPI:1316547235
Name:DENNIS-EASON, BRYANNE
Entity Type:Individual
Prefix:
First Name:BRYANNE
Middle Name:
Last Name:DENNIS-EASON
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 1:8670 W CHEYENNE AVE STE 135
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-7460
Mailing Address - Country:US
Mailing Address - Phone:702-883-2686
Mailing Address - Fax:702-839-2060
Practice Address - Street 1:8670 W CHEYENNE AVE STE 135
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-7460
Practice Address - Country:US
Practice Address - Phone:702-883-2686
Practice Address - Fax:702-839-2060
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide