Individual
STACEY BRYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
170 GOVERNORS AVE, HALLMARK HEALTH SYSTEM, INC., MEDFORD, MA 02155-1643
(781) 306-6000
(781) 306-6085
Mailing address
170 GOVERNORS AVE, HALLMARK HEALTH SYSTEM, INC., MEDFORD, MA 02155-1643
(781) 306-6000
(781) 306-6085
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
215935
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1200992
—
MA
Enumeration date
01/09/2006
Last updated
05/20/2013
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