MEDICARE: JASON BERMAN CRNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	1087527	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1-087527	OTHER	AL	ALABAMA BOARD OF NURSING

General Provider Information

NPI Number	:	1013953314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON BERMAN CRNP

Provider Business Mailing Address
First Line	:	25442 AL HIGHWAY 127
Second Line	:
City	:	ELKMONT
State	:	AL
Zip	:	35620-6608
Country	:	US
Telephone Number	:	256-732-3712
Fax Number	:	256-732-3714

Provider Business Practice Location Address
First Line	:	25442 AL HIGHWAY 127
Second Line	:
City	:	ELKMONT
State	:	AL
Zip	:	35620-6608
Country	:	US
Telephone Number	:	256-732-3712
Fax Number	:	256-732-3714

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	12/04/2014

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Directions to “ JASON BERMAN CRNP” Practice Location

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