Provider Demographics
NPI:1578554838
Name:SERAFINI, JO ANN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:JO
Middle Name:ANN
Last Name:SERAFINI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1171 AMBER WAY
Mailing Address - Street 2:
Mailing Address - City:OWINGS
Mailing Address - State:MD
Mailing Address - Zip Code:20736-3501
Mailing Address - Country:US
Mailing Address - Phone:410-286-3825
Mailing Address - Fax:
Practice Address - Street 1:2568A RIVA RD
Practice Address - Street 2:SUITE 103
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7445
Practice Address - Country:US
Practice Address - Phone:410-224-7667
Practice Address - Fax:410-224-7007
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR148953363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics