Provider Demographics
NPI:1790104297
Name:BRYANT, CHRISTIAN (NP-C)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:
Last Name:BRYANT
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 RIPPAVILLA ST
Mailing Address - Street 2:
Mailing Address - City:SALTILLO
Mailing Address - State:MS
Mailing Address - Zip Code:38866-5784
Mailing Address - Country:US
Mailing Address - Phone:662-660-4188
Mailing Address - Fax:
Practice Address - Street 1:571 MITCHELL ST
Practice Address - Street 2:SUITE C
Practice Address - City:GUNTOWN
Practice Address - State:MS
Practice Address - Zip Code:38849-8500
Practice Address - Country:US
Practice Address - Phone:662-348-3342
Practice Address - Fax:662-348-2772
Is Sole Proprietor?:No
Enumeration Date:2014-04-11
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR882507363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner