Healthcare Provider Details

I. General information

NPI: 1053492488
Provider Name (Legal Business Name): JOAN T SERKIN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 45TH ST
WEST PALM BEACH FL
33407-2413
US

IV. Provider business mailing address

8295 PINION DR
LAKE WORTH FL
33467-1122
US

V. Phone/Fax

Practice location:
  • Phone: 561-881-2980
  • Fax: 561-881-0941
Mailing address:
  • Phone: 561-881-2980
  • Fax: 561-881-0941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number175532RN
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: