Serenson-Ungar, Diane L

Serenson-Ungar, Diane L is an individual health care provider with primary practice located at 2885 W Howard Nickell Rd , Fayetteville AR 72704-5459. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Serenson-Ungar, Diane L can be contacted via phone (479) 409-5267.

Contact Information

Primary practice address
2885 W Howard Nickell Rd Fayetteville AR 72704-5459
Phone: (479) 409-5267
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 330652 New York
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X A001004 Arkansas
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X A01004ANP Arkansas

Profile Details

NPI number 1245266360
LBN Legal business name Serenson-Ungar, Diane L
Credentials Advanced Practice Nurse (APN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2006
Last updated Sep 10th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245266360 NPPES
Arkansas Other 5T997 AR BC/BS
Arkansas MEDICAID 136354758 AR BC/BS

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