Provider Demographics
NPI:1639985682
Name:SERENEMIND NP IN ADULT HEALTH & PSYCHIATRY PLLC
Entity type:Organization
Organization Name:SERENEMIND NP IN ADULT HEALTH & PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:BEAUBRUN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:631-987-4989
Mailing Address - Street 1:150 MOTOR PKWY STE 401
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-5108
Mailing Address - Country:US
Mailing Address - Phone:631-260-2288
Mailing Address - Fax:631-350-0570
Practice Address - Street 1:150 MOTOR PKWY STE 401
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-5108
Practice Address - Country:US
Practice Address - Phone:631-260-2280
Practice Address - Fax:631-350-0570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health