Healthcare Provider Details

I. General information

NPI: 1326517301
Provider Name (Legal Business Name): EMILY RUTH BRYANT R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2018
Last Update Date: 11/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2574 FRAYSER BLVD
MEMPHIS TN
38127-5829
US

IV. Provider business mailing address

1923 SULPHUR SPRINGS RD
MORRISTOWN TN
37813-5654
US

V. Phone/Fax

Practice location:
  • Phone: 901-302-4361
  • Fax: 865-342-0121
Mailing address:
  • Phone: 423-317-9344
  • Fax: 423-714-2355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number232310
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: