MEDICARE: MRS. JO ANN SERAFINI CRNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	R148953	MD

General Provider Information

NPI Number	:	1578554838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JO ANN SERAFINI CRNP

Provider Business Mailing Address
First Line	:	1171 AMBER WAY
Second Line	:
City	:	OWINGS
State	:	MD
Zip	:	20736-3501
Country	:	US
Telephone Number	:	410-286-3825
Fax Number	:

Provider Business Practice Location Address
First Line	:	2568A RIVA RD
Second Line	:	SUITE 103
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-7445
Country	:	US
Telephone Number	:	410-224-7667
Fax Number	:	410-224-7007

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	07/08/2007

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