Grace Bryan, PAC
Physician Assistant in Jacksonville, FL. Individual provider (NPI-1).
NPI number1003897232
StatusActive
Last updated in NPPESSep 1, 2020
Details
- NPI
- 1003897232
- Entity type
- Individual (NPI-1)
- Name
- Grace Bryan
- Credential
- PAC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 5, 2005
- Certification date
- Sep 1, 2020
- Last updated
- Sep 1, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA3590 | FL | Yes |
Practice location
4500 San Pablo Rd SJacksonville, FL 32224-1865
Phone 904-953-2000
Mailing address
4500 San Pablo Rd SJacksonville, FL 32224-1865
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