MRS. KENISHA LEANDRA BRYANT WHNP NPI 1811295850

NPI Information

NPI: 1811295850
Provider Name: MRS. KENISHA LEANDRA BRYANT, WHNP
Classification: Nurse Practitioner - 363LW0102X
Entity Type: Individual

Specialization: Women's Health

PECOS Registration: Yes

Address:
4901 FOREST PARK AVE STE 341
STE 341
SAINT LOUIS, MO
ZIP 63108
Phone: (314) 454-7882
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MRS. Kenisha Leandra Bryant, WHNP is a women's health nurse practitioner in Saint Louis, MO. MRS. Kenisha Leandra Bryant, WHNP NPI is 1811295850. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4901 FOREST PARK AVE STE 341
STE 341
SAINT LOUIS, MO
ZIP 63108-453
Phone: (314) 454-7882
Fax: (314) 454-5167

The NPI 1811295850 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/28/2011 and was last updated on 1/24/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LW0102X	Nurse Practitioner	Women's Health	2002018066	MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	ENROLLED	MEDICAID	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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