Provider Demographics
NPI:1598493694
Name:SERBANICA, MEREDITH LEE (DNP, APRN, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:MEREDITH
Middle Name:LEE
Last Name:SERBANICA
Suffix:
Gender:F
Credentials:DNP, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:676 HAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29860-9422
Mailing Address - Country:US
Mailing Address - Phone:619-993-4049
Mailing Address - Fax:
Practice Address - Street 1:676 HAMPTON DR
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29860-9422
Practice Address - Country:US
Practice Address - Phone:619-993-4049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-08
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95021850363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health