Provider Demographics
NPI:1528804879
Name:BRYANT, SUSAN (RN, IBCLC)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:BRYANT
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 OLD HARMONY RD
Mailing Address - Street 2:
Mailing Address - City:N SCITUATE
Mailing Address - State:RI
Mailing Address - Zip Code:02857-1326
Mailing Address - Country:US
Mailing Address - Phone:401-451-0228
Mailing Address - Fax:401-451-0228
Practice Address - Street 1:221 LONGWOOD AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5817
Practice Address - Country:US
Practice Address - Phone:617-525-4120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-06
Last Update Date:2024-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA133209163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant