Individual
JESSICA W BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN, MSN
Contact information
Practice address
2111 WILSON RD, NEWBERRY, SC 29108-1603
(803) 321-2170
(803) 321-2300
Mailing address
644 FIELD CREEK RD, RUFFIN, SC 29475-4144
(843) 599-0833
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
209620
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
E17149
—
SC
Enumeration date
03/19/2014
Last updated
03/19/2014
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