Provider Demographics
NPI:1588829592
Name:BRYANT, KRISTEN OVERMAN (OD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:OVERMAN
Last Name:BRYANT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:505 W HOLLIS ST STE 109
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-1386
Mailing Address - Country:US
Mailing Address - Phone:603-882-0311
Mailing Address - Fax:603-417-2982
Practice Address - Street 1:505 W HOLLIS ST STE 109
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-1386
Practice Address - Country:US
Practice Address - Phone:603-882-0311
Practice Address - Fax:603-417-2982
Is Sole Proprietor?:No
Enumeration Date:2008-07-20
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0827152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist