Provider Demographics
NPI:1386126431
Name:BRYANT, LUCIE JEAN (LM, CPM)
Entity type:Individual
Prefix:MRS
First Name:LUCIE
Middle Name:JEAN
Last Name:BRYANT
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5036 7TH ST
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-2132
Mailing Address - Country:US
Mailing Address - Phone:813-377-2229
Mailing Address - Fax:
Practice Address - Street 1:5036 7TH ST
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-2132
Practice Address - Country:US
Practice Address - Phone:813-377-2229
Practice Address - Fax:813-364-6439
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW369176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife