Provider Demographics
NPI:1659891869
Name:BRYANT, RHONDA MICHELLE (APRN)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:MICHELLE
Last Name:BRYANT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3661 W HIGHWAY 92
Mailing Address - Street 2:
Mailing Address - City:STEARNS
Mailing Address - State:KY
Mailing Address - Zip Code:42647-7102
Mailing Address - Country:US
Mailing Address - Phone:606-310-9992
Mailing Address - Fax:
Practice Address - Street 1:2157 S HIGHWAY 27
Practice Address - Street 2:
Practice Address - City:STEARNS
Practice Address - State:KY
Practice Address - Zip Code:42647-6297
Practice Address - Country:US
Practice Address - Phone:606-376-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9419099363LF0000X
KY3011328363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRSYGXOtherFL BCBS
FL023651400Medicaid