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NPI Code Detail

MEDICARE: MICHAELLE BRYANT NP

MEDICARE:   MICHAELLE  BRYANT  NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner743758TX
2363L00000XNurse Practitioner8039MN
3363L00000XNurse Practitioner5016113NC

General Provider Information

NPI Number : 1033428016
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAELLE BRYANT NP
Provider Business Mailing Address
First Line : PO BOX 60447
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-0447
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 125 QUEENS RD STE 610&640
Second Line :
City : CHARLOTTE
State : NC
Zip : 28204-3278
Country : US
Telephone Number : 980-302-6600
Fax Number : 980-302-6605
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2010
Last Update Date : 10/31/2025

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Directions to “ MICHAELLE BRYANT NP” Practice Location

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