Individual
TRAVIS LEON BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
110 29TH AVE N, STE 202, NASHVILLE, TN 37203-1401
(615) 327-4304
Mailing address
110 29TH AVE N, STE 202, NASHVILLE, TN 37203-1401
(615) 327-4304
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
80402
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200345160A
—
OK
Enumeration date
01/06/2009
Last updated
11/07/2011
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