Individual
KALLIE CHAPMAN BERETTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4401 RIVERCHASE DR, PHENIX CITY, AL 36867-7483
(334) 732-3000
Mailing address
224 JASMINE HILL RD, INDIAN SPRINGS, AL 35124-3328
(334) 202-5596
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-149837
AL
367500000X
Certified Registered Nurse Anesthetist
26463
SC
367500000X
Certified Registered Nurse Anesthetist
8423336
NV
367500000X
Certified Registered Nurse Anesthetist
APRN-195940
MT
367500000X
Certified Registered Nurse Anesthetist
RN2339414
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110164311A
—
MA
Enumeration date
04/14/2020
Last updated
06/17/2025
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