Provider Demographics
NPI:1912897083
Name:ROYAL SERENITY HEALTHCARE, LLC
Entity type:Organization
Organization Name:ROYAL SERENITY HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN MSN FNP-BC PMHNP-BC
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:LASHAWN
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-271-8280
Mailing Address - Street 1:10573 CROSSBACK LN
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-6682
Mailing Address - Country:US
Mailing Address - Phone:239-402-7439
Mailing Address - Fax:239-230-2964
Practice Address - Street 1:10573 CROSSBACK LN
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-6682
Practice Address - Country:US
Practice Address - Phone:239-402-7439
Practice Address - Fax:239-230-2964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty