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General NPI Number Information
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NPI Number | 1538419809
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Entity Type | Individual
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Provider Name | JINA BRYANT NP
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Gender | Female
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Dates
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Enumeration Date | 09/14/2012
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Last Update Date | 12/05/2017
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Provider Practice Location Address
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Address Line | 1361 CORTINA DR STE A
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City | ORLAND
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State | CA
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Zip | 95963-2402
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Country | US
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Telephone | 530-865-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 699 TOWNSEND CT.
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City | CHICO
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State | CA
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Zip | 95926
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 23188
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License Number State | CA
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