Provider Demographics
NPI:1386769578
Name:BRYANT, BETH C (APRN)
Entity type:Individual
Prefix:MS
First Name:BETH
Middle Name:C
Last Name:BRYANT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Mailing Address - Street 1:1120 15TH ST
Mailing Address - Street 2:BA 8300
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30912-0004
Mailing Address - Country:US
Mailing Address - Phone:706-446-5802
Mailing Address - Fax:706-721-3838
Practice Address - Street 1:960 JOHNSON FERRY RD STE 130
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1601
Practice Address - Country:US
Practice Address - Phone:404-300-2990
Practice Address - Fax:404-300-2986
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN061119363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health