Provider Demographics
NPI:1659094530
Name:SERENITY CENTER FOR HEALTH & WELLNESS
Entity Type:Organization
Organization Name:SERENITY CENTER FOR HEALTH & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:443-774-8259
Mailing Address - Street 1:9608 BOUNDLESS SHADE TER
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-1490
Mailing Address - Country:US
Mailing Address - Phone:443-774-8259
Mailing Address - Fax:
Practice Address - Street 1:9608 BOUNDLESS SHADE TER
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20723-1490
Practice Address - Country:US
Practice Address - Phone:443-774-8259
Practice Address - Fax:443-214-0542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-26
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care