Healthcare Provider Details

I. General information

NPI: 1114876448
Provider Name (Legal Business Name): SERENITY PATH HOSPICE CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2026
Last Update Date: 01/28/2026
Certification Date: 01/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9621 BIA RD 21
BELCOURT ND
58316
US

IV. Provider business mailing address

PO BOX 1182
BELCOURT ND
58316-1182
US

V. Phone/Fax

Practice location:
  • Phone: 701-278-2387
  • Fax:
Mailing address:
  • Phone: 701-278-2387
  • Fax: 701-278-2387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number State

VIII. Authorized Official

Name: BRIANA MARIE JEANOTTE
Title or Position: OWNER
Credential: MSN-RN
Phone: 701-278-2387