Provider Demographics
NPI:1548387319
Name:BRYANT, JONANNA ROCHELLE (RN)
Entity Type:Individual
Prefix:MRS
First Name:JONANNA
Middle Name:ROCHELLE
Last Name: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 1:6529 N 20TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19138-3101
Mailing Address - Country:US
Mailing Address - Phone:215-549-3252
Mailing Address - Fax:215-549-3252
Practice Address - Street 1:6529 N 20TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19138-3101
Practice Address - Country:US
Practice Address - Phone:215-549-3252
Practice Address - Fax:215-549-3252
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN317674L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse