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General NPI Number Information
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NPI Number | 1245105048
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Entity Type | Organization
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Legal Business Name | SERENITY PA PSYCHIATRIC SERVICES PLLC
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Dates
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Enumeration Date | 10/09/2025
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 5904 PINE TREE CT
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City | RALEIGH
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State | NC
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Zip | 27609-4244
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Country | US
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Telephone | 910-802-0979
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Fax | 919-583-6411
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Provider Business Mailing Address
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Address Line | 5904 PINE TREE CT
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City | RALEIGH
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State | NC
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Zip | 27609-4244
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Country | US
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Telephone | 910-802-0979
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Fax | 919-583-6411
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Authorized Official
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Title or Position | PA
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Name | KRISTINE ASHTON
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Credential | PA
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Telephone | 910-802-0979
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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