Provider Demographics
NPI:1447821541
Name:SERAFINI, JENNIFER JAE (LPN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JAE
Last Name:SERAFINI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 HARVARD BLVD
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-1242
Mailing Address - Country:US
Mailing Address - Phone:740-381-7934
Mailing Address - Fax:
Practice Address - Street 1:247 HARVARD BLVD
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-1242
Practice Address - Country:US
Practice Address - Phone:740-381-7934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA300501164W00000X
WV32596164W00000X
OH146137164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse