| NPI | 1689172389 |
|---|---|
| Former Name | WANDA FAYE BRYANT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5010233) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 232094) |
| Enumeration Date | 2018-01-28 |
| Last Update Date | 2023-09-12 |