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General NPI Number Information
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NPI Number | 1194090795
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Entity Type | Individual
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Provider Name | KIMBERLY LEE BRYANT CNA
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Gender | Female
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Dates
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Enumeration Date | 03/14/2012
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Last Update Date | 03/14/2012
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Provider Practice Location Address
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Address Line | 28201 SW 126TH CT APT 2
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City | HOMESTEAD
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State | FL
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Zip | 33033-1286
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Country | US
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Telephone | 786-237-6723
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Fax | 305-257-0111
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Provider Business Mailing Address
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Address Line | 28201 SW 126TH CT APT 2
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City | HOMESTEAD
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State | FL
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Zip | 33033-1286
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Country | US
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Telephone | 786-237-6723
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Fax | 305-257-0111
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 0601900004581
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License Number State | FL
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