Individual
MICHAEL SERRANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3505-A WESTERN AVE, KINGMAN, AZ 86409
(928) 757-8111
(928) 757-3256
Mailing address
3707 N STOCKTON HILL RD STE B, KINGMAN, AZ 86409-0507
(928) 757-8111
(928) 757-3256
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP8025
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
045089
—
AZ
01
—
AP8025
AZ BN
AZ
01
—
RN187990
AZ NB
AZ
Enumeration date
08/17/2015
Last updated
09/12/2022
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