Provider Demographics
NPI:1003623927
Name:ANNANG, JOHN BRYAN PILARIZA (CRNP)
Entity type:Individual
Prefix:
First Name:JOHN BRYAN
Middle Name:PILARIZA
Last Name:ANNANG
Suffix:
Gender:M
Credentials:CRNP
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Mailing Address - Street 1:1309 COFFEEN AVE STE 1200
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-5777
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:273 PENINSULA FARM RD STE F
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MD
Practice Address - Zip Code:21012-1012
Practice Address - Country:US
Practice Address - Phone:443-827-7113
Practice Address - Fax:443-200-0265
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-13
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDAC007109363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health