Provider Demographics
NPI:1508056300
Name:BRYSON, MARTI ANN (RN)
Entity Type:Individual
Prefix:MISS
First Name:MARTI
Middle Name:ANN
Last Name:BRYSON
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 1:2607B MANN RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-0933
Mailing Address - Country:US
Mailing Address - Phone:615-812-0444
Mailing Address - Fax:
Practice Address - Street 1:2607B MANN RD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-0933
Practice Address - Country:US
Practice Address - Phone:615-812-0444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN149703163W00000X
CORN179616163W00000X
FLRN9235179163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse