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Georgetta S Serdynski

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

9900 Bren Rd E, Minnetonka, MN 55343-9664

PECOS Enrollment

Based on the most recent information from CMS, provider Georgetta S Serdynski does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 10 days ago.

Profile Details

Provider ID
1295816163
Provider Type
Individual
Full Name
Serdynski, Georgetta S
Title
Mrs.
Credential
FNP

Gender
Female
Sole Proprietor
No
Enumeration Date
10/18/2006
Last Updated
7/16/2020

Contact Information

Practice Location

9900 Bren Rd E, Minnetonka, MN 55343-9664

(414) 687-1852

Unlisted Fax

Mailing Location

1321 S 54th St, W Milwaukee, WI 53214-3404

(414) 687-1852

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 2956 Wisconsin

Provider Identifiers

ID	Description	Issuer
ID 36016900	Description Medicaid	Issuer Unlisted Wisconsin

Georgetta S Serdynski

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Cox, Traci

Shirley, Grace A

Berry, Wakiya

Alexander, Gweneth L

Depas, Shelby A

Graf, Angelita L

Hocking, Tracey L

Summers, Dyan J

Thayer, Lisa

Sullivan, Elizabeth Mary