Provider Demographics
NPI:1003696329
Name:SERENE WELLNESS AND MEDSPA LLC
Entity Type:Organization
Organization Name:SERENE WELLNESS AND MEDSPA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNOR
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:405-240-8218
Mailing Address - Street 1:7608 HAROLD DR
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-9743
Mailing Address - Country:US
Mailing Address - Phone:405-240-8218
Mailing Address - Fax:
Practice Address - Street 1:6051 N BROOKLINE AVE STE 138-B
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4289
Practice Address - Country:US
Practice Address - Phone:405-240-8218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service