Provider Demographics
NPI:1134600059
Name:SERNA, CELINA (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:CELINA
Middle Name:
Last Name:SERNA
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4052 FM 2782
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75964-5255
Mailing Address - Country:US
Mailing Address - Phone:936-556-3615
Mailing Address - Fax:
Practice Address - Street 1:507 JACOB ST
Practice Address - Street 2:
Practice Address - City:TIMPSON
Practice Address - State:TX
Practice Address - Zip Code:75975-5255
Practice Address - Country:US
Practice Address - Phone:936-254-3338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP138153363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care