Healthcare Provider Details

I. General information

NPI: 1063155166
Provider Name (Legal Business Name): SERAH KURIA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2022
Last Update Date: 04/16/2022
Certification Date: 04/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14700 4TH ST APT 108
LAUREL MD
20707-3899
US

IV. Provider business mailing address

14700 4TH ST APT 108
LAUREL MD
20707-3899
US

V. Phone/Fax

Practice location:
  • Phone: 240-421-8971
  • Fax:
Mailing address:
  • Phone: 240-421-8971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberR4628R
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: