Provider Demographics
NPI:1710962303
Name:BRYANT, LYNNE LOUISE (CNP)
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:LOUISE
Last Name:BRYANT
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2619 COLONIAL DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-4948
Mailing Address - Country:US
Mailing Address - Phone:406-442-1231
Mailing Address - Fax:406-442-6857
Practice Address - Street 1:2619 COLONIAL DR
Practice Address - Street 2:SUITE A
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4948
Practice Address - Country:US
Practice Address - Phone:406-442-1231
Practice Address - Fax:406-442-6857
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2015-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTRN016334363LW0102X
MT16334363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0433719Medicaid
MT043719Medicaid
M011004635Medicare PIN
MTS09963Medicare UPIN
MT000080340Medicare ID - Type Unspecified
MT0433719Medicaid