Provider Demographics
NPI:1760240758
Name:BRYANT, KAYLA MARIE (RMA)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:MARIE
Last Name:BRYANT
Suffix:
Gender:F
Credentials:RMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 BUFFALO DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-5083
Mailing Address - Country:US
Mailing Address - Phone:864-385-9020
Mailing Address - Fax:
Practice Address - Street 1:105 BUFFALO DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-5083
Practice Address - Country:US
Practice Address - Phone:864-385-9020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2895981164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse