Provider Demographics
NPI:1063220556
Name:BRYSON, JOYCE ELAINE
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:ELAINE
Last Name:BRYSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1442 HACKWORTH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43207-4491
Mailing Address - Country:US
Mailing Address - Phone:614-857-5716
Mailing Address - Fax:
Practice Address - Street 1:1442 HACKWORTH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43207-4491
Practice Address - Country:US
Practice Address - Phone:614-857-5716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
376K00000X-AID251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health