Healthcare Provider Details

I. General information

NPI: 1780756197
Provider Name (Legal Business Name): ROXANNE R. BRYANT FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 08/30/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 FAYETTEVILLE ST
DURHAM NC
27707-2325
US

IV. Provider business mailing address

626 ABBEY HALL WAY
CARY NC
27513-1688
US

V. Phone/Fax

Practice location:
  • Phone: 919-956-4000
  • Fax: 919-776-0130
Mailing address:
  • Phone: 919-629-7501
  • Fax: 919-776-0130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201143
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: