Basic Information
| Provider Information | |||||||||
| NPI: | 1841219177 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRYANT | ||||||||
| FirstName: | MARGARET | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1801 N. SENATE BLVD. | ||||||||
| Address2: | SUITE 755 | ||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462021260 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3179231787 | ||||||||
| FaxNumber: | 3179629186 | ||||||||
| Practice Location | |||||||||
| Address1: | 1801 N. SENATE BLVD. | ||||||||
| Address2: | SUITE 755 | ||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462021260 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3179231787 | ||||||||
| FaxNumber: | 3179629186 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2006 | ||||||||
| LastUpdateDate: | 07/10/2013 | ||||||||
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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 | 71001352A | IN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 200906840 | 05 | IN | MEDICAID |