Latabitha Bryant

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

License

041528835 Issued in IL

Practice address

10736 Lamon Ave
Oak Lawn, IL 60453-5419

Phone

(773) 791-5364

NPI assigned

Sep 20, 2024

Last updated

Sep 20, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1726790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1508683624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10736 LAMON AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604535419",
            "telephone_number": "773-791-5364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10736 LAMON AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604535419",
            "telephone_number": "773-791-5364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "LATABITHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-20",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "IL",
            "license": "041528835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tatyana Denise Bruce Gardner
• Kari Gardes Bruce, MD
• Tashica Bruce, FNP
• Robert J Bruno, M.D.
• Sabrina Marijane Bruozas, DO
• Rosemarie Bryce, L.C.P.C.
• David Brzezniak
• Leslie Buckner, PT
• Diana Maria Budz
• Aline Aparecida Bujas, DNP, CPNP-AC

• General Practice Registered Nurse in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• General Practice Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.