MEDICARE: SERENE-JOURNEY WELLNESS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1447181615
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENE-JOURNEY WELLNESS

Provider Business Mailing Address
First Line	:	4889 LAKE WORTH RD STE 109
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33463-3480
Country	:	US
Telephone Number	:	561-928-5105
Fax Number	:

Provider Business Practice Location Address
First Line	:	4889 LAKE WORTH RD STE 109
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33463-3480
Country	:	US
Telephone Number	:	561-928-5105
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	KERRY-ANN TAMEKA SMITH
Credential	:	NP
Telephone Number	:	561-928-5105

Provider Enumeration Date	:	05/27/2026
Last Update Date	:	05/27/2026

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