Provider Demographics
NPI:1942059134
Name:BRYANT, JAYDEN
Entity type:Individual
Prefix:
First Name:JAYDEN
Middle Name:
Last Name:BRYANT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 BLADENSBURG RD NE APT 301
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-2234
Mailing Address - Country:US
Mailing Address - Phone:202-855-4920
Mailing Address - Fax:
Practice Address - Street 1:3001 BLADENSBURG RD NE APT 301
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-2234
Practice Address - Country:US
Practice Address - Phone:202-855-4920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-18
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant