Provider Demographics
NPI:1639972805
Name:SERRANO, MARTHA (FNP)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:
Last Name:SERRANO
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3102 MARLOWE RD N
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27896-8921
Mailing Address - Country:US
Mailing Address - Phone:252-315-2576
Mailing Address - Fax:
Practice Address - Street 1:275 BETHESDA DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-7217
Practice Address - Country:US
Practice Address - Phone:252-752-5077
Practice Address - Fax:252-752-9544
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC172941163WU0100X, 163W00000X
NC5021921363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WU0100XNursing Service ProvidersRegistered NurseUrology
No163W00000XNursing Service ProvidersRegistered Nurse