MEDICARE: KATE ELIZABETH BRYANT PA

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	363A00000X	Physician Assistant	0010-16468	NC
2	363A00000X	Physician Assistant	50.006043RX	OH

General Provider Information

NPI Number	:	1528611415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATE ELIZABETH BRYANT PA

Provider Business Mailing Address
First Line	:	664 JASONWAY AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43214-2424
Country	:	US
Telephone Number	:	513-407-0370
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 THOMAS LN STE 3G
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43214-1419
Country	:	US
Telephone Number	:	614-788-2870
Fax Number	:

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

Provider Enumeration Date	:	07/19/2019
Last Update Date	:	05/13/2026

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Directions to “ KATE ELIZABETH BRYANT PA” Practice Location

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