Healthcare Provider Details

I. General information

NPI: 1437806908
Provider Name (Legal Business Name): SHAERRICE D BRYANT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2022
Last Update Date: 03/04/2022
Certification Date: 03/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1217 CAREY AVE
AKRON OH
44314-1976
US

IV. Provider business mailing address

1217 CAREY AVE
AKRON OH
44314-1976
US

V. Phone/Fax

Practice location:
  • Phone: 330-813-4158
  • Fax:
Mailing address:
  • Phone: 330-813-4158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1710I1003X
TaxonomyIndependent Duty Medical Technicians
License Number1710L1003X
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: