MEDICARE: DESTINY BRYANT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency		NV

General Provider Information

NPI Number	:	1922573815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DESTINY BRYANT

Provider Business Mailing Address
First Line	:	2900 SUNRIDGE HEIGHTS PKWY APT 528
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-4476
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2900 SUNRIDGE HEIGHTS PKWY APT 528
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-4476
Country	:	US
Telephone Number	:	702-955-8318
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/08/2018
Last Update Date	:	06/09/2026

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Directions to “ DESTINY BRYANT ” Practice Location

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