Healthcare Provider Details

I. General information

NPI: 1285876284
Provider Name (Legal Business Name): ROBERTA M BERMAN GNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2009
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1208 CHOCTAW TRL
BRENTWOOD TN
37027-7410
US

IV. Provider business mailing address

1208 CHOCTAW TRL
BRENTWOOD TN
37027-7410
US

V. Phone/Fax

Practice location:
  • Phone: 615-645-3031
  • Fax: 615-678-5676
Mailing address:
  • Phone: 615-645-3031
  • Fax: 615-678-5676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number7523
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: