MEDICARE: MRS. DEVIN YVONNE BRYANT RN

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	163WC1500X	Community Health Registered Nurse		OR

General Provider Information

NPI Number	:	1992980734
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEVIN YVONNE BRYANT RN

Provider Business Mailing Address
First Line	:	1650 COCHRANE CIR
Second Line	:	EVANS ARMY COMMUNITY HOSPITAL, ATTN: CREDENTIALS OFFICE
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80913-4603
Country	:	US
Telephone Number	:	719-526-7844
Fax Number	:	719-526-7984

Provider Business Practice Location Address
First Line	:	1650 COCHRANE CIR
Second Line	:	EVANS ARMY COMMUNITY HOSPITAL, ATTN: MCXE-PMD/PHN
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80913-4603
Country	:	US
Telephone Number	:	719-526-2939
Fax Number	:	719-526-7181

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

Provider Enumeration Date	:	12/28/2007
Last Update Date	:	12/28/2007

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