Individual
BRYAN ADAMS
Active
Individual
BRYAN ADAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
197032-4405
UT
363LF0000X
Family Nurse Practitioner
Primary
197032-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500018008
PALMETTO
UT
01
—
61565
PEHP
UT
Enumeration date
09/27/2006
Last updated
09/12/2017
Update your record
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