MEDICARE: KATIE L SEREMET NP

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
1	363L00000X	Nurse Practitioner	154499	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144534140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIE L SEREMET NP

Provider Business Mailing Address
First Line	:	6452 CITY WEST PKWY
Second Line	:
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55344-3245
Country	:	US
Telephone Number	:	952-999-0333
Fax Number	:	952-300-2558

Provider Business Practice Location Address
First Line	:	6452 CITY WEST PKWY
Second Line	:
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55344-3245
Country	:	US
Telephone Number	:	952-999-0333
Fax Number	:	952-300-2558

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2010
Last Update Date	:	03/22/2015

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