Provider Demographics
NPI:1063929495
Name:PENA SERRANO, SONIA MARIA (CRNA)
Entity type:Individual
Prefix:
First Name:SONIA
Middle Name:MARIA
Last Name:PENA SERRANO
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 ALPEN STRASSE
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-3429
Mailing Address - Country:US
Mailing Address - Phone:915-525-8761
Mailing Address - Fax:
Practice Address - Street 1:2000 TRANS MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79911-3601
Practice Address - Country:US
Practice Address - Phone:915-215-5666
Practice Address - Fax:915-215-5047
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-08
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA120599367500000X
TXAP136648367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered