Provider Demographics
NPI:1891410015
Name:BRYANT, KASSIE JEANETTE (FNP)
Entity type:Individual
Prefix:
First Name:KASSIE
Middle Name:JEANETTE
Last Name:BRYANT
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:KASSIE
Other - Middle Name:
Other - Last Name:HOUSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:HOUSER
Mailing Address - Street 1:600 SUN TEMPLE DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-8643
Mailing Address - Country:US
Mailing Address - Phone:256-975-4291
Mailing Address - Fax:
Practice Address - Street 1:400 E 10TH ST
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-4716
Practice Address - Country:US
Practice Address - Phone:256-288-3333
Practice Address - Fax:775-227-8344
Is Sole Proprietor?:No
Enumeration Date:2022-10-10
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-121161363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily