Individual
JENNIFER BRYCE
Active
Individual
JENNIFER BRYCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601002383
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265551097
—
MI
01
—
500H274490
BCBSM GROUP PIN MHP
MI
01
—
DS0605
RAIL ROAD MEDICARE GROUP PIN MHP
MI
01
—
MI4989
MEDICARE GROUP PTAN MHP
MI
01
—
MI4989416
MEDICARE PTAN MHP
MI
Enumeration date
03/29/2007
Last updated
06/30/2014
Update your record
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