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NPI 1255872875

NPI 1255872875 : BRYAN BERRY APRN, FNP-BC, ONP-C : SHELBYVILLE, TN

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General NPI Number Information
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    NPI Number           |    1255872875
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    Entity Type          |    Individual 
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    Provider Name        |    BRYAN BERRY APRN, FNP-BC, ONP-C
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/15/2017
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    Last Update Date     |    04/24/2025
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Provider Practice Location Address
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    Address Line         |    1401 N MAIN ST 
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    City                 |    SHELBYVILLE
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    State                |    TN
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    Zip                  |    37160-2316
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    Country              |    US
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    Telephone            |    931-488-8895
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    Fax                  |    931-488-8856
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Provider Business Mailing Address
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    Address Line         |    3024 BUSINESS PARK CIR 
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    City                 |    GOODLETTSVILLE
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    State                |    TN
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    Zip                  |    37072-3132
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    Country              |    US
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    Telephone            |    615-239-2018
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363LP2300X
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    Taxonomy Name        |    Primary Care Nurse Practitioner
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    License Number       |    22364
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    License Number State |    TN
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Taxonomy #2
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    Taxonomy Code        |    363LF0000X
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    Taxonomy Name        |    Family Nurse Practitioner
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    License Number       |    22364
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    License Number State |    TN
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