Provider Demographics
NPI:1538964028
Name:DISCISCIO, SERENA ROSE (LNA)
Entity type:Individual
Prefix:
First Name:SERENA
Middle Name:ROSE
Last Name:DISCISCIO
Suffix:
Gender:
Credentials:LNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 S MAIN ST APT 19
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03246-3818
Mailing Address - Country:US
Mailing Address - Phone:603-497-1068
Mailing Address - Fax:
Practice Address - Street 1:53 HARVEST RD
Practice Address - Street 2:
Practice Address - City:CHICHESTER
Practice Address - State:NH
Practice Address - Zip Code:03258-6545
Practice Address - Country:US
Practice Address - Phone:603-497-1068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH065673-24376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide