Healthcare Provider Details

I. General information

NPI: 1245194273
Provider Name (Legal Business Name): SERENITY SPRINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2025
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6017 E RICHARDS DR
SHAWNEE KS
66216-1777
US

IV. Provider business mailing address

6017 E RICHARDS DR
SHAWNEE KS
66216-1777
US

V. Phone/Fax

Practice location:
  • Phone: 913-636-8827
  • Fax: 913-232-9806
Mailing address:
  • Phone: 913-636-8827
  • Fax: 913-232-9806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TABBY NDANU TUITOEK
Title or Position: OPERATOR
Credential: APRN
Phone: 913-636-8827