Provider Demographics
NPI:1245067248
Name:SERAPHYM HEALTHCARE LLC
Entity type:Organization
Organization Name:SERAPHYM HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:SHENEAKA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SYKES
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:470-294-1087
Mailing Address - Street 1:368 W PIKE ST STE 106
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-3240
Mailing Address - Country:US
Mailing Address - Phone:470-294-1087
Mailing Address - Fax:470-294-1086
Practice Address - Street 1:368 W PIKE ST STE 106
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-3240
Practice Address - Country:US
Practice Address - Phone:470-294-1087
Practice Address - Fax:470-294-1086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty