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General NPI Number Information
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NPI Number | 1962727487
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Entity Type | Individual
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Provider Name | KERRI BRYAN PA
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Gender | Female
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Dates
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Enumeration Date | 03/29/2010
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 8229 SHOAL CREEK BLVD STE 105
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City | AUSTIN
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State | TX
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Zip | 78757-7556
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Country | US
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Telephone | 737-738-5046
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Fax |
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Provider Business Mailing Address
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Address Line | 132 SPLENDOR CIR
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City | MURRELLS INLET
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State | SC
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Zip | 29576-7086
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Country | US
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Telephone | 912-508-2502
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | TL1550
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA60436
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 001012262
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA20240118
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License Number State | NM
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Taxonomy #5
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA70012874
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License Number State | WA
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Taxonomy #6
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 10563
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License Number State | AZ
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Taxonomy #7
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 5333
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License Number State | OK
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Taxonomy #8
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA15324
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License Number State | TX
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