Individual
MRS. JENNIFER ANN SERBACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
1220 WILLIS AVE, DAYTONA BEACH, FL 32114-2810
(800) 539-4228
Mailing address
150 MAGNOLIA AVE, DAYTONA BEACH, FL 32114-4304
(800) 539-4228
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11041109
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129060000
—
FL
Enumeration date
08/02/2021
Last updated
12/18/2025
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