Provider Demographics
NPI:1639115983
Name:BRYANT, CHARLOTTE MARSEE (RN,C)
Entity Type:Individual
Prefix:MRS
First Name:CHARLOTTE
Middle Name:MARSEE
Last Name:BRYANT
Suffix:
Gender:F
Credentials:RN,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4324 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23803-6524
Mailing Address - Country:US
Mailing Address - Phone:804-732-4590
Mailing Address - Fax:
Practice Address - Street 1:26014 COX RD
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23803-6566
Practice Address - Country:US
Practice Address - Phone:804-862-8040
Practice Address - Fax:804-862-8089
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001147183163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health