Healthcare Provider Details
I. General information
NPI: 1730010265
Provider Name (Legal Business Name): SERENI HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3576 COVINGTON HWY STE 206E
DECATUR GA
30032-1800
US
IV. Provider business mailing address
3576 COVINGTON HWY STE 206E
DECATUR GA
30032-1800
US
V. Phone/Fax
- Phone: 770-600-2458
- Fax: 770-600-2459
- Phone: 770-600-2458
- Fax: 770-600-2459
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PRINCESS
SAMARRA
WISE
Title or Position: OWNER-FNP
Credential: APRN, FNP-BC
Phone: 706-248-3330