Provider Demographics
NPI:1417101270
Name:BRYANT, BRIAN WILLARD (ARNP)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:WILLARD
Last Name:BRYANT
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3107 SW 21ST ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-3245
Mailing Address - Country:US
Mailing Address - Phone:785-296-5326
Mailing Address - Fax:785-291-3511
Practice Address - Street 1:3107 SW 21ST ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-3245
Practice Address - Country:US
Practice Address - Phone:785-296-5326
Practice Address - Fax:785-291-3511
Is Sole Proprietor?:No
Enumeration Date:2008-11-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-53996-081363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily