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General NPI Number Information
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NPI Number | 1871801605
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Entity Type | Individual
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Provider Name | TAKIMA BRYANT NP
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Gender | Female
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Dates
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Enumeration Date | 09/14/2010
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 11000 OPTUM CIR
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City | EDEN PRAIRIE
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State | MN
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Zip | 55344-2503
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Country | US
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Telephone | 888-445-8745
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Fax |
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Provider Business Mailing Address
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Address Line | 101 CENTERPOINT DR STE 215
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City | MIDDLETOWN
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State | CT
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Zip | 06457-7568
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Country | US
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Telephone | 888-964-6681
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 336436
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5927
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License Number State | CT
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