Provider Demographics
NPI:1134818008
Name:FRENCH, BRYAN
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:
Last Name:FRENCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3567 RESERVE COMMONS DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-5344
Mailing Address - Country:US
Mailing Address - Phone:330-664-9250
Mailing Address - Fax:
Practice Address - Street 1:3567 RESERVE COMMONS DR STE 100
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-5344
Practice Address - Country:US
Practice Address - Phone:330-664-9250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0032863363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health