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NPI Code Detail

MEDICARE: MS. BARBARA JO BRYANT

MEDICARE: MS. BARBARA JO BRYANT
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
1163WP0809XAdult Psychiatric/Mental Health Registered NurseR028640ME
2163WP0809XAdult Psychiatric/Mental Health Registered Nurse2105432FL
3363LP0808XPsychiatric/Mental Health Nurse Practitioner796818TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134160138
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BARBARA JO BRYANT
Provider Business Mailing Address
First Line : 2590 E LUCAS DR
Second Line :
City : BEAUMONT
State : TX
Zip : 77703-1129
Country : US
Telephone Number : 727-967-7272
Fax Number :
Provider Business Practice Location Address
First Line : 2750 S 8TH ST
Second Line :
City : BEAUMONT
State : TX
Zip : 77701-7719
Country : US
Telephone Number : 409-839-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2006
Last Update Date : 06/10/2011

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