Individual
KIESA NICHOL BRYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2772 RUTLAND RD, DAVIDSONVILLE, MD 21035-1228
(410) 721-0311
(443) 607-1041
Mailing address
PO BOX 6725, ANNAPOLIS, MD 21401-0725
(410) 721-0311
(443) 607-1041
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0002692
MD
Other
Enumeration date
11/30/2007
Last updated
11/30/2007
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