MEDICARE: TONYA BRYANT FNP

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	2255A2300X	Athletic Trainer	30315	SC
2	363L00000X	Nurse Practitioner	30315	SC

General Provider Information

NPI Number	:	1568355105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONYA BRYANT FNP

Provider Business Mailing Address
First Line	:	622A OLD EASLEY HWY
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29611-6521
Country	:	US
Telephone Number	:	864-992-3883
Fax Number	:

Provider Business Practice Location Address
First Line	:	622A OLD EASLEY HWY
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29611-6521
Country	:	US
Telephone Number	:	864-992-3883
Fax Number	:

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

Provider Enumeration Date	:	06/02/2025
Last Update Date	:	09/15/2025

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Directions to “ TONYA BRYANT FNP” Practice Location

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