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General NPI Number Information
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NPI Number | 1639776446
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Entity Type | Organization
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Legal Business Name | SERENITY HEART HEALTHCARE, LLC
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Dates
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Enumeration Date | 10/05/2020
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 1532 SPEEN CT
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City | HANOVER
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State | MD
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Zip | 21076-1753
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Country | US
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Telephone | 410-921-0118
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Fax |
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Provider Business Mailing Address
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Address Line | 1532 SPEEN CT
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City | HANOVER
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State | MD
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Zip | 21076-1753
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Country | US
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Telephone | 410-299-4603
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Fax |
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Authorized Official
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Title or Position | PMHNP-BC, FNP-BC/OWNER
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Name | MRS. MICHELLE A TUCKER-JONES
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Credential | FNP-BC, PMHNP-BC
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Telephone | 410-299-4603
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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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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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