Provider Demographics
NPI:1548929201
Name:BRYANT, KATRINA LYNN (CNA)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:LYNN
Last Name:BRYANT
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3219 N OSPREY AVE FL 34234
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34234-6143
Mailing Address - Country:US
Mailing Address - Phone:941-735-8556
Mailing Address - Fax:
Practice Address - Street 1:3219 N OSPREY AVE FL 34234
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34234-6143
Practice Address - Country:US
Practice Address - Phone:941-735-8556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-09
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CNA319083376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide