Provider Demographics
NPI:1336859966
Name:BILLINGSLEY, SERENA
Entity Type:Individual
Prefix:
First Name:SERENA
Middle Name:
Last Name:BILLINGSLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 SAGAMORE AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44103-4159
Mailing Address - Country:US
Mailing Address - Phone:330-240-3359
Mailing Address - Fax:216-245-4429
Practice Address - Street 1:7700 SAGAMORE AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-4159
Practice Address - Country:US
Practice Address - Phone:216-527-7199
Practice Address - Fax:216-245-4429
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide