Provider Demographics
NPI:1437028081
Name:BERRYMAN, REVA
Entity type:Individual
Prefix:
First Name:REVA
Middle Name:
Last Name:BERRYMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:REVA
Other - Middle Name:
Other - Last Name:NESTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:512 JENNY LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353-1733
Mailing Address - Country:US
Mailing Address - Phone:859-697-9554
Mailing Address - Fax:
Practice Address - Street 1:512 JENNY LN
Practice Address - Street 2:
Practice Address - City:MOUNT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-1733
Practice Address - Country:US
Practice Address - Phone:859-697-9554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-03
Last Update Date:2025-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife