Individual
BETHANY BRYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18610 FENKELL ST, DETROIT, MI 48223-2378
(313) 723-6000
(313) 424-4058
Mailing address
25670 W 12 MILE RD APT 304, SOUTHFIELD, MI 48034-8014
(313) 285-6418
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704295004
MI
363LA2100X
Acute Care Nurse Practitioner
Primary
4704295004
MI
Other
Enumeration date
07/02/2019
Last updated
03/20/2023
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