Provider Demographics
NPI:1770294340
Name:BRYCE, MERCEDES JANE (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:MERCEDES
Middle Name:JANE
Last Name:BRYCE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 COMMUNITY DR APT 1509
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-2750
Mailing Address - Country:US
Mailing Address - Phone:772-370-5676
Mailing Address - Fax:
Practice Address - Street 1:208 NE 19TH DR
Practice Address - Street 2:
Practice Address - City:OKEECHOBEE
Practice Address - State:FL
Practice Address - Zip Code:34972-1932
Practice Address - Country:US
Practice Address - Phone:866-228-7676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11023032363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty