Provider Demographics
NPI:1740507011
Name:BRYAN, ANNA-MARIE (RN)
Entity type:Individual
Prefix:MS
First Name:ANNA-MARIE
Middle Name:
Last Name:BRYAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:ANNA-MARIE
Other - Middle Name:
Other - Last Name:LIGHTNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:2434 MCDONALD HILL RD
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:OH
Mailing Address - Zip Code:45628-9574
Mailing Address - Country:US
Mailing Address - Phone:740-701-9496
Mailing Address - Fax:
Practice Address - Street 1:2434 MCDONALD HILL RD
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:OH
Practice Address - Zip Code:45628-9574
Practice Address - Country:US
Practice Address - Phone:740-701-9496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-27
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN115768164W00000X
OHRN 366920163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse