Provider Demographics
NPI:1609190362
Name:BRYANT, LESLEY G (RN, MSN, ARNP, FNP-C)
Entity Type:Individual
Prefix:MS
First Name:LESLEY
Middle Name:G
Last Name:BRYANT
Suffix:
Gender:F
Credentials:RN, MSN, ARNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-2321
Mailing Address - Country:US
Mailing Address - Phone:502-564-3333
Mailing Address - Fax:
Practice Address - Street 1:275 E MAIN ST
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-2321
Practice Address - Country:US
Practice Address - Phone:502-564-3333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-23
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6390P363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily