Individual
JILL BRYANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2615 E 15TH ST, JOPLIN, MO 64804-1006
(417) 624-4701
Mailing address
2615 E 15TH ST, JOPLIN, MO 64804-1006
(417) 624-4701
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2020021034
MO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
2020021034
MO
Other
Enumeration date
09/02/2020
Last updated
06/05/2025
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