Provider Demographics
NPI:1427821370
Name:SERINO, RENEE JENNIFER (INDEPENDENT PROVIDER)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:JENNIFER
Last Name:SERINO
Suffix:
Gender:F
Credentials:INDEPENDENT PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3874 WYNDHAM RIDGE DR APT 310
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-6171
Mailing Address - Country:US
Mailing Address - Phone:330-795-5866
Mailing Address - Fax:
Practice Address - Street 1:5874 WYNDHAM RIDGE DR.
Practice Address - Street 2:APT 310
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224
Practice Address - Country:US
Practice Address - Phone:330-795-5866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No172A00000XOther Service ProvidersDriver
No376J00000XNursing Service Related ProvidersHomemaker