Provider Demographics
NPI:1386304582
Name:BERETTA, JAIME MARIE (CRNP)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:MARIE
Last Name:BERETTA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4075 MONROEVILLE BLVD STE 125
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2526
Mailing Address - Country:US
Mailing Address - Phone:724-600-5114
Mailing Address - Fax:
Practice Address - Street 1:4075 MONROEVILLE BLVD STE 125
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2526
Practice Address - Country:US
Practice Address - Phone:412-373-1717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP022743363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care