Provider Demographics
NPI:1902221997
Name:SERNA, BLAIR CHARLENE (MSN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:BLAIR
Middle Name:CHARLENE
Last Name:SERNA
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:BLAIR
Other - Middle Name:CHARLENE
Other - Last Name:RUIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, FNP-C
Mailing Address - Street 1:755 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:SILSBEE
Mailing Address - State:TX
Mailing Address - Zip Code:77656-3802
Mailing Address - Country:US
Mailing Address - Phone:409-386-1222
Mailing Address - Fax:409-385-0472
Practice Address - Street 1:755 N 4TH ST
Practice Address - Street 2:
Practice Address - City:SILSBEE
Practice Address - State:TX
Practice Address - Zip Code:77656-3802
Practice Address - Country:US
Practice Address - Phone:409-386-1222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-27
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX771648363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily