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General NPI Number Information
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NPI Number | 1477404481
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Entity Type | Organization
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Legal Business Name | SERENITY MEDICAL LLC
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Dates
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Enumeration Date | 02/05/2026
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 813 W WASHINGTON ST
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City | SUFFOLK
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State | VA
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Zip | 23434-6104
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Country | US
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Telephone | 757-912-4819
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Fax |
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Provider Business Mailing Address
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Address Line | 813 W WASHINGTON ST
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City | SUFFOLK
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State | VA
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Zip | 23434-6104
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Country | US
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Telephone | 757-912-4819
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | TAMMISE HASTINGS STINE
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Credential | FNP-BC
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Telephone | 757-729-5529
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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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