Provider Demographics
NPI:1497936058
Name:BRYANT, JASON C (CRNA)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:C
Last Name:BRYANT
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:MR
Other - First Name:JASON
Other - Middle Name:C
Other - Last Name:BRYANT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 74994
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44194-1077
Mailing Address - Country:US
Mailing Address - Phone:330-837-7354
Mailing Address - Fax:330-830-1659
Practice Address - Street 1:400 AUSTIN AVE NW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-3554
Practice Address - Country:US
Practice Address - Phone:330-837-7354
Practice Address - Fax:330-830-1659
Is Sole Proprietor?:No
Enumeration Date:2007-11-23
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN275382367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered