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General NPI Number Information
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NPI Number | 1790195758
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Entity Type | Individual
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Provider Name | JESSICA BRYANT
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Gender | Female
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Dates
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Enumeration Date | 04/30/2014
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Last Update Date | 12/22/2021
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Provider Practice Location Address
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Address Line | BRIGHAM AND WOMEN'S HOSPITAL 75 FRANCIS ST
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City | BOSTON
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State | MA
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Zip | 02115
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Country | US
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Telephone | 617-732-5384
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Fax |
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Provider Business Mailing Address
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Address Line | 500 PARNASSUS AVE MU 320 WEST
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-2203
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Country | US
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Telephone | 415-476-6548
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 278247
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License Number State | MA
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