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Active NPI 1295320489 Individual Practitioner Female Practitioner

Serina Johnson

Licensed Practical Nurse • Edgewood, NM

Professional Overview & Biography Verified Profile Summary

Serina Johnson is a registered healthcare professional specializing in Licensed Practical Nurse in Edgewood, NM. Practice services are available at 104 QUAIL TRAIL under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

104 Quail Trail
Unit B

Edgewood, NM 87015

Telephone 5052080204

Specialty Benchmarks & Practice Insights

Comparative analytics for Licensed Practical Nurse in Edgewood, NM

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
1 Specialists

Practicing in Edgewood, NM (173 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2021-03-09
Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

State License CO PN.0045666

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

8 Associated Practitioners
Vivienne Prinz , CNP

Nurse Practitioner - Family

NPI 1194154823

Certified Nurse Practitioner

Thu Nguyen , FNP

Nurse Practitioner - Family

NPI 1205459369

Family Nurse Practitioner

Mary Crow , FNP-C

Nurse Practitioner - Primary Care

NPI 1215576905

Family Nurse Practitioner (Certified)

Cierra Dorado

Nurse Practitioner - Family

NPI 1386251957
NPI 1669796595

Doctor of Medicine (M.D.)

Jodi Dettman , CNP

Nurse Practitioner - Adult Health

NPI 1720269178

Certified Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active March 09, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location March 09, 2021

Registered at 104 QUAIL TRAIL, UNIT B, EDGEWOOD, NM 87015 (Tel: 5052080204)

📍
Updated Business Mailing Address March 09, 2021

Registered at 104 QUAIL TRAIL, UNIT B, EDGEWOOD, NM 87015 (Tel: 5052080204)

👤
Provider Name / Credentials Updated March 09, 2021

Recorded as SERINA JOHNSON

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 09, 2021

Licensed Practical Nurse (License #PN.0045666 in CO)

🟢
Initial NPI Registration & Enumeration March 09, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1295320489
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 09, 2021
Last Update: March 09, 2021
Sole Proprietor: No

Mailing Address

104 Quail Trail, Unit B

Edgewood, NM 87015

Phone: 5052080204

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.