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General NPI Number Information
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NPI Number | 1396347571
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Entity Type | Individual
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Provider Name | RACHEL BRYAN NP
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Gender | Female
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Dates
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Enumeration Date | 11/12/2020
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Last Update Date | 11/12/2020
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Provider Practice Location Address
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Address Line | 3131 MAPLE DR NE
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City | ATLANTA
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State | GA
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Zip | 30305-2515
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Country | US
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Telephone | 404-841-8450
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Fax |
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Provider Business Mailing Address
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Address Line | 2015 WINDERMERE XING
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City | CUMMING
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State | GA
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Zip | 30041-6106
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Country | US
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Telephone |
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Fax |
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | RN249164
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License Number State | ID
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