Provider Demographics
NPI:1851151781
Name:DENNARD, BRIA
Entity Type:Individual
Prefix:
First Name:BRIA
Middle Name:
Last Name:DENNARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 LORRAINE AVE
Mailing Address - Street 2:
Mailing Address - City:AMERICUS
Mailing Address - State:GA
Mailing Address - Zip Code:31709-3234
Mailing Address - Country:US
Mailing Address - Phone:478-244-1433
Mailing Address - Fax:
Practice Address - Street 1:212 LORRAINE AVE
Practice Address - Street 2:
Practice Address - City:AMERICUS
Practice Address - State:GA
Practice Address - Zip Code:31709-3234
Practice Address - Country:US
Practice Address - Phone:478-244-1433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-19
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy