Healthcare Provider Details

I. General information

NPI: 1790677698
Provider Name (Legal Business Name): ELIZABETH SERPAS
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2025
Last Update Date: 07/16/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 EAST COLLEGE AVENUE
UNIVERSITY PARK PA
16802
US

IV. Provider business mailing address

6410 MARSHAL FOCH ST
NEW ORLEANS LA
70124-3920
US

V. Phone/Fax

Practice location:
  • Phone: 814-863-0245
  • Fax:
Mailing address:
  • Phone: 504-390-1296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN136055
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: