Provider Demographics
NPI:1699300855
Name:DIME, CERENA INAPAN (NP)
Entity type:Individual
Prefix:MRS
First Name:CERENA
Middle Name:INAPAN
Last Name:DIME
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:MEREDITH
Mailing Address - State:NH
Mailing Address - Zip Code:03253-6304
Mailing Address - Country:US
Mailing Address - Phone:603-937-1679
Mailing Address - Fax:
Practice Address - Street 1:2800 GODWIN BLVD FL 1
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-8038
Practice Address - Country:US
Practice Address - Phone:757-934-4821
Practice Address - Fax:757-934-4276
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-09
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH05905723363L00000X
VA0024186316363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner