Provider Demographics
NPI:1518735430
Name:BRYAN, JAYDA (RN)
Entity Type:Individual
Prefix:
First Name:JAYDA
Middle Name:
Last Name:BRYAN
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 1:6501 RED HOOK PLZ STE 201
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802-1373
Mailing Address - Country:US
Mailing Address - Phone:340-643-1069
Mailing Address - Fax:
Practice Address - Street 1:1 ZUFRIEDENHEIT
Practice Address - Street 2:
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-0080
Practice Address - Country:US
Practice Address - Phone:340-643-1069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI1221163W00000X
174N00000X, 374J00000X, 174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No163W00000XNursing Service ProvidersRegistered Nurse
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
No374J00000XNursing Service Related ProvidersDoula