Individual
JASHANEA LATRICE BRYANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2457 MLK JR DR SW, ATLANTA, GA 30311-1712
(678) 515-8154
Mailing address
3836 WALDROP LN, DECATUR, GA 30034-6789
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F10230644
GA
Other
Enumeration date
12/19/2023
Last updated
12/19/2023
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