Healthcare Provider Details

I. General information

NPI: 1447712443
Provider Name (Legal Business Name): BRIAN WALTER BERNSTEIN RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2019
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2740 VILLAGE PROFESSIONAL DR
OPELIKA AL
36801-2379
US

IV. Provider business mailing address

2740 VILLAGE PROFESSIONAL DR
OPELIKA AL
36801-2379
US

V. Phone/Fax

Practice location:
  • Phone: 334-749-3411
  • Fax:
Mailing address:
  • Phone: 334-528-3871
  • Fax: 334-528-3888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-153584
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number1-153584
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1-153584
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: