Provider Demographics
NPI:1316557101
Name:SERENITY HEALTH CLINIC PLLC
Entity Type:Organization
Organization Name:SERENITY HEALTH CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVEY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:701-202-8789
Mailing Address - Street 1:2705 SUNSET DR UNIT B
Mailing Address - Street 2:
Mailing Address - City:MANDAN
Mailing Address - State:ND
Mailing Address - Zip Code:58554-1547
Mailing Address - Country:US
Mailing Address - Phone:701-751-1060
Mailing Address - Fax:
Practice Address - Street 1:2705 SUNSET DR UNIT B
Practice Address - Street 2:
Practice Address - City:MANDAN
Practice Address - State:ND
Practice Address - Zip Code:58554-1547
Practice Address - Country:US
Practice Address - Phone:701-751-1060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-05
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty