Provider Demographics
NPI:1194724526
Name:SEROTA, JO ANN ELIZABETH (RN, CRNP)
Entity type:Individual
Prefix:MS
First Name:JO ANN
Middle Name:ELIZABETH
Last Name:SEROTA
Suffix:
Gender:F
Credentials:RN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:602 S BETHLEHEM PIKE
Mailing Address - Street 2:SUITE D
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-5800
Mailing Address - Country:US
Mailing Address - Phone:215-643-7771
Mailing Address - Fax:215-643-9463
Practice Address - Street 1:602 S BETHLEHEM PIKE
Practice Address - Street 2:SUITE D
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-5800
Practice Address - Country:US
Practice Address - Phone:215-643-7771
Practice Address - Fax:215-643-9463
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP000880D363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics