Individual
MR. BRYAN KELLY JAYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
300 W HOSPITAL RD, FORT GORDON, GA 30905
(256) 655-1299
Mailing address
300 W HOSPITAL RD, FORT GORDON, GA 30905
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
1-107000
AL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN275511
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN275511
CRNP
GA
Enumeration date
03/06/2014
Last updated
07/31/2025
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