Provider Demographics
NPI:1033631395
Name:HORINOUCHI, SERENA ELISE (FNP)
Entity Type:Individual
Prefix:
First Name:SERENA
Middle Name:ELISE
Last Name:HORINOUCHI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8175 BURGUNDY CIR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-1292
Mailing Address - Country:US
Mailing Address - Phone:530-592-6090
Mailing Address - Fax:
Practice Address - Street 1:531 SIGNAL MOUNTAIN RD # 217
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37405-1925
Practice Address - Country:US
Practice Address - Phone:423-668-0101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-07
Last Update Date:2017-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000022042363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily