Provider Demographics
NPI:1053114025
Name:BRYANT, DEONKA
Entity type:Individual
Prefix:
First Name:DEONKA
Middle Name:
Last Name:BRYANT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6272 S SAGINAW RD # 1086
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-2705
Mailing Address - Country:US
Mailing Address - Phone:800-771-6340
Mailing Address - Fax:
Practice Address - Street 1:6272 S SAGINAW RD # 1086
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-2705
Practice Address - Country:US
Practice Address - Phone:800-771-6340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide