Provider Demographics
NPI:1407550981
Name:WILLIAMS-BRYANT, LAUREN (RN)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:
Last Name:WILLIAMS-BRYANT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 CLINIC AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-4454
Mailing Address - Country:US
Mailing Address - Phone:770-214-2800
Mailing Address - Fax:770-214-2803
Practice Address - Street 1:690 DALLAS HWY STE 103
Practice Address - Street 2:
Practice Address - City:VILLA RICA
Practice Address - State:GA
Practice Address - Zip Code:30180-1265
Practice Address - Country:US
Practice Address - Phone:770-214-2800
Practice Address - Fax:770-214-2803
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-28
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN210993163W00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse