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General NPI Number Information
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NPI Number | 1518737527
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Entity Type | Individual
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Provider Name | MARJEANNA GWEN BRYANT APRN
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Gender | Female
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Dates
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Enumeration Date | 01/02/2024
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Last Update Date | 01/02/2024
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Provider Practice Location Address
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Address Line | 1800 PEACHTREE ST NE SUITE 500
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City | ATLANTA
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State | GA
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Zip | 30309
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Country | US
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Telephone | 770-702-0101
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Fax |
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Provider Business Mailing Address
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Address Line | 5360 ALLATOONA GTWY APT 1203
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City | ACWORTH
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State | GA
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Zip | 30101-7411
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Country | US
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Telephone | 770-878-0910
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | RN209216
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License Number State | GA
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