Provider Demographics
NPI:1699577825
Name:SERRANO, YALISSA (BSN RN)
Entity type:Individual
Prefix:
First Name:YALISSA
Middle Name:
Last Name:SERRANO
Suffix:
Gender:
Credentials:BSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 ORANGE ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01510-2216
Mailing Address - Country:US
Mailing Address - Phone:508-847-0406
Mailing Address - Fax:
Practice Address - Street 1:79 ORANGE ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MA
Practice Address - Zip Code:01510-2216
Practice Address - Country:US
Practice Address - Phone:508-847-0406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2330414163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse