Individual
MRS. JOEY LYNNE BRYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RN, CNSPMH
Contact information
Practice address
616 W RUSSELL PL, SAN ANTONIO, TX 78212-3658
(800) 257-8715
(800) 819-1655
Mailing address
2700 WESTWOOD LN, GEORGETOWN, TX 78628-3351
(512) 930-5594
Taxonomy
Speciality
Code
Description
License number
State
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
605829
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159380802
—
TX
01
—
8N3959
BLUE CROSS BLUE SHIELD
TX
Enumeration date
06/22/2006
Last updated
07/08/2007
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