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NPI Code Detail

MEDICARE: NATASHA BRYANT

MEDICARE:   NATASHA  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
1156FX1800XOptician2191NC

General Provider Information

NPI Number : 1134975493
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATASHA BRYANT
Provider Business Mailing Address
First Line : 670 LILLINGTON HWY
Second Line :
City : SPRING LAKE
State : NC
Zip : 28390-2119
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 670 LILLINGTON HWY
Second Line :
City : SPRING LAKE
State : NC
Zip : 28390-2119
Country : US
Telephone Number : 910-436-7995
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2024
Last Update Date : 04/27/2024

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Directions to “ NATASHA BRYANT ” Practice Location

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