Healthcare Provider Details

I. General information

NPI: 1851206106
Provider Name (Legal Business Name): SERENITY WEIGHT LOSS & WELLNESS CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 BYRAM PL STE A
BYRAM MS
39272-8735
US

IV. Provider business mailing address

310 BYRAM PL STE A
BYRAM MS
39272-8735
US

V. Phone/Fax

Practice location:
  • Phone: 601-559-3266
  • Fax: 601-981-9958
Mailing address:
  • Phone: 601-559-3266
  • Fax: 601-981-9958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHAUNDA FREEMAN
Title or Position: NURSE PRACTITIONER
Credential: FNP-BC
Phone: 601-559-3266