Wanda Lynn Sermon, LPN
Individual provider Active NPI Licensed Practical Nurse · Paterson, NJ
NPI 1063100162 · NPPES record last updated Apr 26, 2023
Key facts
- NPI
- 1063100162
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 26NP07315800 (NJ)
- Practice address
- 350 Preakness Ave
Paterson, NJ 07502-1757 - Phone
- (973) 595-1075
- NPI assigned
- Apr 26, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NP07315800 | NJ | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current |
Accepting new patients | |
| Walgreen Co | Past |
Accepting new patients |
Locations
350 Preakness Ave
Paterson, NJ 07502
Phone (973) 595-1075
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 26NP07315800 | NJ | Yes |
Addresses
Primary practice location
350 Preakness Ave
Paterson, NJ 07502-1757
Mailing address
1266 Teaneck Rd Apt 8
Teaneck, NJ 07666-4947
Phone (917) 567-5989
Other providers in Paterson, NJ
- Jacob A Seltzer
- Nicholas Bohdan Semeniuk
- Sourav Sen
- Senior Care Centers of America, Inc.
- Farinaz Sepahifar
- Georgina Maria Sesana
- Monique G. Severe
- Rehan Hassanin Seyam
- Donald Sgroi
- Glorious Ali Shabazz
All providers in Paterson, NJ · Licensed Practical Nurse in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 26, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.