Individual
MRS. RENITA SMALLEY BRYANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, NP-C
Contact information
Practice address
420 GUNBY AVE, BASTROP, LA 71220-4406
(318) 283-3920
(318) 239-8920
Mailing address
PO BOX 293, BASTROP, LA 71221-0293
(318) 283-3920
(318) 239-8920
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP06499
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2167219
—
LA
Enumeration date
06/28/2011
Last updated
11/19/2019
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