Provider Demographics
NPI:1356239081
Name:WILLIAMS, BRYAN ANTHONY
Entity type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:ANTHONY
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5905 CAMDEN AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-1726
Mailing Address - Country:US
Mailing Address - Phone:402-250-2050
Mailing Address - Fax:
Practice Address - Street 1:4606 N 56TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104-2270
Practice Address - Country:US
Practice Address - Phone:402-250-2050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion