Provider Demographics
NPI:1710645270
Name:BRYANT, CHRISTINE IONEY (NP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:IONEY
Last Name:BRYANT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9116 HARDESTY DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-4701
Mailing Address - Country:US
Mailing Address - Phone:301-613-3950
Mailing Address - Fax:
Practice Address - Street 1:9116 HARDESTY DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-4701
Practice Address - Country:US
Practice Address - Phone:301-613-3950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-02
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024184381363LG0600X
MDR088124163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163W00000XNursing Service ProvidersRegistered Nurse