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General NPI Number Information
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NPI Number | 1588235642
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Entity Type | Individual
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Provider Name | HEATHER BRYAN PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/08/2021
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Last Update Date | 04/08/2026
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Provider Practice Location Address
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Address Line | 2016 1ST AVE
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City | SUMMERVILLE
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State | SC
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Zip | 29486-0408
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Country | US
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Telephone | 843-873-4545
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Fax | 843-873-1561
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Provider Business Mailing Address
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Address Line | 3020 HASWELL ST APT 1212
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City | DANIEL ISLAND
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State | SC
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Zip | 29492-6411
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Country | US
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Telephone | 864-787-3382
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 29285
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 5014564
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 29285A
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License Number State | SC
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