Provider Demographics
NPI:1659005759
Name:SERENITY HEALTH PLLC
Entity Type:Organization
Organization Name:SERENITY HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:I
Authorized Official - Last Name:HERCZEG
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:406-414-7978
Mailing Address - Street 1:301 N 1ST ST UNIT 3
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MT
Mailing Address - Zip Code:59840-2527
Mailing Address - Country:US
Mailing Address - Phone:406-414-7978
Mailing Address - Fax:406-414-7979
Practice Address - Street 1:301 N 1ST ST UNIT 3
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840-2527
Practice Address - Country:US
Practice Address - Phone:406-414-7978
Practice Address - Fax:406-414-7979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-13
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care