Provider Demographics
NPI:1033459805
Name:SERRATOS, RAYE MARIE (APNP, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:RAYE
Middle Name:MARIE
Last Name:SERRATOS
Suffix:
Gender:F
Credentials:APNP, PMHNP-BC
Other - Prefix:
Other - First Name:RAYE
Other - Middle Name:M
Other - Last Name:VINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1244 WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53403-1987
Mailing Address - Country:US
Mailing Address - Phone:262-627-9073
Mailing Address - Fax:
Practice Address - Street 1:1244 WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53403-1987
Practice Address - Country:US
Practice Address - Phone:262-627-9073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-15
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI190012-30163W00000X
WI16235-33363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse