Healthcare Provider Details

I. General information

NPI: 1013372960
Provider Name (Legal Business Name): JENEH SERRY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2015
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11550 STEWART LN APT.504
SILVER SPRING MD
20904-2269
US

IV. Provider business mailing address

11550 STEWART LN APT.504
SILVER SPRING MD
20904-2269
US

V. Phone/Fax

Practice location:
  • Phone: 301-366-3379
  • Fax:
Mailing address:
  • Phone: 301-366-3379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLPN1004374
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN1047777
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: