Healthcare Provider Details

I. General information

NPI: 1942948823
Provider Name (Legal Business Name): AMBER HOLLIDAY BRYANT NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2022
Last Update Date: 07/30/2023
Certification Date: 07/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MEDICAL CENTER DR
HAZARD KY
41701-9421
US

IV. Provider business mailing address

210 BLACK GOLD BLVD STE 106
HAZARD KY
41701-2620
US

V. Phone/Fax

Practice location:
  • Phone: 606-439-1331
  • Fax:
Mailing address:
  • Phone: 606-436-0711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3017798
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: