Provider Demographics
NPI:1154861730
Name:SERS, ANNA (RN PMHCNS)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:SERS
Suffix:
Gender:F
Credentials:RN PMHCNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 REILLY RD
Mailing Address - Street 2:
Mailing Address - City:LAGRANGEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12540-6100
Mailing Address - Country:US
Mailing Address - Phone:845-227-1545
Mailing Address - Fax:
Practice Address - Street 1:179 REILLY RD
Practice Address - Street 2:
Practice Address - City:LAGRANGEVILLE
Practice Address - State:NY
Practice Address - Zip Code:12540-6100
Practice Address - Country:US
Practice Address - Phone:845-227-1545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-02
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYM265783-1163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult