Individual
CYAN BRYAN-JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.N
Contact information
Practice address
11647 INWOOD ST, JAMAICA, NY 11436-1349
(646) 272-9553
Mailing address
11647 INWOOD ST, JAMAICA, NY 11436-1349
(646) 272-9553
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
311774
NY
Other
Enumeration date
10/02/2012
Last updated
10/02/2012
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