Provider Demographics
NPI:1215521497
Name:BRYANT, ANN MARIE (FNP)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:BRYANT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:MARIE
Other - Last Name:PAXTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13914 SOUTHEASTERN PKWY STE 302
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-7126
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13914 SOUTHEASTERN PKWY STE 302
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-7126
Practice Address - Country:US
Practice Address - Phone:317-415-9404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-27
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28184496A163W00000X
IN71010893A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse