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NPI Code Detail

MEDICARE: MRS. KELSEY ELIZABETH-EVE SERNA-ZIMMERMAN RN, PHN

MEDICARE: MRS. KELSEY ELIZABETH-EVE SERNA-ZIMMERMAN RN, PHN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WC1500XCommunity Health Registered NurseRN 835297CA

General Provider Information

NPI Number : 1134542277
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KELSEY ELIZABETH-EVE SERNA-ZIMMERMAN RN, PHN
Provider Business Mailing Address
First Line : 5730 PACKARD AVE STE 100
Second Line :
City : MARYSVILLE
State : CA
Zip : 95901-7117
Country : US
Telephone Number : 530-749-6831
Fax Number :
Provider Business Practice Location Address
First Line : 5730 PACKARD AVE STE 100
Second Line :
City : MARYSVILLE
State : CA
Zip : 95901-7117
Country : US
Telephone Number : 530-749-6831
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2014
Last Update Date : 01/24/2014

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