MEDICARE: RICHARD 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
1	163WE0003X	Emergency Registered Nurse	RN148855	LA

General Provider Information

NPI Number	:	1194613059
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD BRYANT

Provider Business Mailing Address
First Line	:	2724 LONG BRANCH DR
Second Line	:
City	:	MARRERO
State	:	LA
Zip	:	70072-5855
Country	:	US
Telephone Number	:	504-432-3134
Fax Number	:

Provider Business Practice Location Address
First Line	:	2724 LONG BRANCH DR
Second Line	:
City	:	MARRERO
State	:	LA
Zip	:	70072-5855
Country	:	US
Telephone Number	:	504-432-3134
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2025
Last Update Date	:	06/27/2025

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Directions to “ RICHARD BRYANT ” Practice Location

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