Healthcare Provider Details

I. General information

NPI: 1982279253
Provider Name (Legal Business Name): SERENITY HEART HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2021
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1532 SPEEN CT
HANOVER MD
21076-1753
US

IV. Provider business mailing address

1532 SPEEN CT
HANOVER MD
21076-1753
US

V. Phone/Fax

Practice location:
  • Phone: 410-921-0118
  • Fax: 443-308-0916
Mailing address:
  • Phone: 410-921-0118
  • Fax: 443-308-0916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE A TUCKER-JONES
Title or Position: OWNER/MEMBER
Credential: PMHNP-BC, FNP-BC
Phone: 410-216-0268