Healthcare Provider Details

I. General information

NPI: 1639082787
Provider Name (Legal Business Name): LINDA M BRYANT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2718 CROYDON DR NW
CANTON OH
44718-3402
US

IV. Provider business mailing address

2718 CROYDON DR NW
CANTON OH
44718-3402
US

V. Phone/Fax

Practice location:
  • Phone: 330-704-2485
  • Fax:
Mailing address:
  • Phone: 330-704-2485
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN196253
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: