Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 175532RN | FL |
NPI | 1053492488 |
---|---|
Provider Name | Joan T Serkin |
First Address | Lake Worth, FL 33467-1122 |
Second Address | West Palm Beach, FL 33407-2413 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 08/07/2007 |