Provider Demographics
NPI:1477178317
Name:SARAZINE, SERNETTA
Entity type:Individual
Prefix:
First Name:SERNETTA
Middle Name:
Last Name:SARAZINE
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 1:7203 GLEN FOREST DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-6185
Mailing Address - Country:US
Mailing Address - Phone:478-733-1109
Mailing Address - Fax:
Practice Address - Street 1:7203 GLEN FOREST DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-6185
Practice Address - Country:US
Practice Address - Phone:478-733-1109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-16
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist