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Individual

CELESTINA DOROTHEA BRYSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
17711 SAN FELIPE BAY, SAN ANTONIO, TX 78255-3340
(501) 765-5866
Mailing address
17711 SAN FELIPE BAY, SAN ANTONIO, TX 78255-3340
(501) 765-5866

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
665386
TX
364SA2100X
Acute Care Clinical Nurse Specialist
665386
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
155388501
TX
01
5A150
BCBS
01
71604624206
QUALCHOICE
Enumeration date
11/17/2006
Last updated
02/12/2016
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