Provider Demographics
NPI:1770658395
Name:SEREBRYAKOVA-REINO, IRINA (FNP)
Entity Type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:SEREBRYAKOVA-REINO
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 1:149 EPPING RD
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-4522
Mailing Address - Country:US
Mailing Address - Phone:603-309-2030
Mailing Address - Fax:
Practice Address - Street 1:149 EPPING RD
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-4522
Practice Address - Country:US
Practice Address - Phone:603-309-2030
Practice Address - Fax:833-371-1471
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2289350363L00000X
NH078790-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner