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General NPI Number Information
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NPI Number | 1538074216
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Entity Type | Individual
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Provider Name | JAY BRYAN RN
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Gender | Male
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Dates
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Enumeration Date | 08/17/2026
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Last Update Date | 08/17/2026
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Provider Practice Location Address
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Address Line | 4750 E BEGICH CIR
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City | WASILLA
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State | AK
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Zip | 99654-7605
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Country | US
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Telephone | 907-531-9217
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Fax | 907-290-5460
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Provider Business Mailing Address
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Address Line | 4750 E BEGICH CIR
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City | WASILLA
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State | AK
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Zip | 99654-7605
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Country | US
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Telephone | 907-531-9217
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Fax | 907-290-5460
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 19735
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License Number State | AK
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