Healthcare Provider Details

I. General information

NPI: 1740507011
Provider Name (Legal Business Name): ANNA-MARIE BRYAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANNA-MARIE LIGHTNER LPN

II. Dates (important events)

Enumeration Date: 04/27/2010
Last Update Date: 01/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2434 MCDONALD HILL RD
FRANKFORT OH
45628-9574
US

IV. Provider business mailing address

2434 MCDONALD HILL RD
FRANKFORT OH
45628-9574
US

V. Phone/Fax

Practice location:
  • Phone: 740-701-9496
  • Fax:
Mailing address:
  • Phone: 740-701-9496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN115768
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN 366920
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: