Provider Demographics
NPI:1851531784
Name:VEROLLA, SERENA J (APRN)
Entity Type:Individual
Prefix:
First Name:SERENA
Middle Name:J
Last Name:VEROLLA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 FARRWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087-1835
Mailing Address - Country:US
Mailing Address - Phone:603-207-3563
Mailing Address - Fax:855-640-8960
Practice Address - Street 1:75 GILCREAST RD STE 210-188
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3564
Practice Address - Country:US
Practice Address - Phone:603-207-3563
Practice Address - Fax:855-640-8960
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-05
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH046137-23363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily