Provider Demographics
NPI:1053569574
Name:BRYANT, KATHRYN CAMPBELL (RPH)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:CAMPBELL
Last Name:BRYANT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4038 THOMAS NELSON HWY
Mailing Address - Street 2:
Mailing Address - City:ARRINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22922-2302
Mailing Address - Country:US
Mailing Address - Phone:434-263-4810
Mailing Address - Fax:434-263-6360
Practice Address - Street 1:4038 THOMAS NELSON HWY
Practice Address - Street 2:
Practice Address - City:ARRINGTON
Practice Address - State:VA
Practice Address - Zip Code:22922-2302
Practice Address - Country:US
Practice Address - Phone:434-263-4810
Practice Address - Fax:434-263-6360
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202011715183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist