Bryan, John R
Bryan, John R is an individual health care provider with primary practice located at Us Hwy 491 North , Shiprock NM 87420. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Bryan, John R can be contacted via phone (505) 368-6401.Contact Information
Primary practice address
Us Hwy 491 North
Shiprock NM 87420
Phone: (505) 368-6401
Fax: (505) 368-6431
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 10000308A | Indiana |
Profile Details
| NPI number | 1497814891 |
|---|---|
| LBN Legal business name | Bryan, John R |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 8th, 2006 |
| Last updated | Jan 3rd, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497814891 | NPPES |
| Colorado | MEDICAID | 26126818 | |
| Colorado | MEDICAID | 74676512 | |
| Colorado | MEDICAID | 918394 |
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