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General NPI Number Information
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NPI Number | 1316557101
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Entity Type | Organization
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Legal Business Name | SERENITY HEALTH CLINIC PLLC
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Dates
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Enumeration Date | 08/05/2020
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Last Update Date | 09/09/2021
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Provider Practice Location Address
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Address Line | 2705 SUNSET DR UNIT B
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City | MANDAN
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State | ND
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Zip | 58554-1547
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Country | US
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Telephone | 701-751-1060
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Fax |
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Provider Business Mailing Address
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Address Line | 2705 SUNSET DR UNIT B
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City | MANDAN
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State | ND
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Zip | 58554-1547
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Country | US
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Telephone | 701-751-1060
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Fax |
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Authorized Official
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Title or Position | FNP/OWNER
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Name | AMANDA LEVEY
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Credential | FNP
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Telephone | 701-202-8789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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