Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | APN0000030125 | TN |
NPI | 1225706427 |
---|---|
Provider Name | Jennifer Serpe |
First Address | Wimauma, FL 33598-0015 |
Second Address | Memphis, TN 38103-2816 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2021 |
Last Update Date | 01/09/2021 |