Provider Demographics
NPI:1679747646
Name:SERA, WILLIAM (ARNP)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:SERA
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7111 PROSPECT PL NE STE D200
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-4337
Mailing Address - Country:US
Mailing Address - Phone:505-369-7200
Mailing Address - Fax:505-796-6154
Practice Address - Street 1:7111 PROSPECT PL NE STE D200
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-4337
Practice Address - Country:US
Practice Address - Phone:505-369-7200
Practice Address - Fax:505-796-6154
Is Sole Proprietor?:No
Enumeration Date:2008-04-21
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2827282363L00000X
FL2827282363LF0000X
NM66190363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner