Provider Demographics
NPI:1285876284
Name:BERMAN, ROBERTA M (GNP-BC)
Entity type:Individual
Prefix:
First Name:ROBERTA
Middle Name:M
Last Name:BERMAN
Suffix:
Gender:
Credentials:GNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 CHOCTAW TRL
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-7410
Mailing Address - Country:US
Mailing Address - Phone:615-645-3031
Mailing Address - Fax:615-678-5676
Practice Address - Street 1:1208 CHOCTAW TRL
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-7410
Practice Address - Country:US
Practice Address - Phone:615-645-3031
Practice Address - Fax:615-678-5676
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7523363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ000035Medicaid