Provider Demographics
NPI:1194244871
Name:SERRE, REBECCA ALLISON (CRNP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ALLISON
Last Name:SERRE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 W CHURCH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:PA
Mailing Address - Zip Code:15501-2269
Mailing Address - Country:US
Mailing Address - Phone:814-445-5099
Mailing Address - Fax:814-444-1852
Practice Address - Street 1:105 W CHURCH ST STE 1
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501-2269
Practice Address - Country:US
Practice Address - Phone:814-445-5099
Practice Address - Fax:814-444-1852
Is Sole Proprietor?:No
Enumeration Date:2017-09-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP017887363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily