Provider Demographics
NPI:1093696312
Name:SEROWKA, ALISHA ANNE
Entity type:Individual
Prefix:
First Name:ALISHA
Middle Name:ANNE
Last Name:SEROWKA
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 1:2903 GOLDENROD AVE
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716-2285
Mailing Address - Country:US
Mailing Address - Phone:307-855-5318
Mailing Address - Fax:
Practice Address - Street 1:2903 GOLDENROD AVE
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-2285
Practice Address - Country:US
Practice Address - Phone:307-855-5318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-11
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator