Provider Demographics
NPI:1689786956
Name:SEREEN, AMELIA S (PA)
Entity Type:Individual
Prefix:
First Name:AMELIA
Middle Name:S
Last Name:SEREEN
Suffix:
Gender:F
Credentials:PA
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:215 N MAIN ST
Mailing Address - Street 2:VAMC
Mailing Address - City:WHITE RIVER JUNCTION
Mailing Address - State:VT
Mailing Address - Zip Code:05009
Mailing Address - Country:US
Mailing Address - Phone:802-295-9363
Mailing Address - Fax:
Practice Address - Street 1:215 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WHITE RIVER JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05009-0001
Practice Address - Country:US
Practice Address - Phone:802-295-9363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical