Basic Information
| Provider Information | |||||||||
| NPI: | 1124586987 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BRYANT | ||||||||
| FirstName: | MARGARET | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | DNP, FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1106 CHUCK DAWLEY BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | MT PLEASANT | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294644195 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8438491551 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1106 CHUCK DAWLEY BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | MT PLEASANT | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294644195 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8438491551 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/11/2019 | ||||||||
| LastUpdateDate: | 03/11/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | APN.21771 | SC | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LF0000X | APN.21771 | SC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.