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General NPI Number Information
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NPI Number | 1699300855
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Entity Type | Individual
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Provider Name | CERENA INAPAN DIME NP
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Gender | Female
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Dates
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Enumeration Date | 03/09/2020
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Last Update Date | 09/27/2023
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Provider Practice Location Address
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Address Line | 2800 GODWIN BLVD FL 1
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City | SUFFOLK
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State | VA
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Zip | 23434-8038
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Country | US
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Telephone | 757-934-4821
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Fax | 757-934-4276
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Provider Business Mailing Address
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Address Line | 28 CIRCLE DR
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City | MEREDITH
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State | NH
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Zip | 03253-6304
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Country | US
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Telephone | 603-937-1679
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 05905723
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0024186316
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License Number State | VA
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