NPI Profile for BRYAN L LOGAN in SPARTA, MO.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner |
| NPI # | 1548450349 |
|
| Status | Active | |
| Credentials | FNP (Family Nurse Practitioner) | |
| Entity | Individual | |
| Enumeration date | 07/27/2007 | |
| Last updated | 01/13/2012 - About 14 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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BRYAN L LOGAN
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| REGIONAL SERVICES 8520 MO-14 SPARTA, MO |