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General NPI Number Information
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NPI Number | 1639985682
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Entity Type | Organization
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Legal Business Name | SERENEMIND NP IN ADULT HEALTH & PSYCHIATRY PLLC
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Dates
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Enumeration Date | 12/05/2024
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Last Update Date | 02/09/2026
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Provider Practice Location Address
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Address Line | 150 MOTOR PKWY STE 401
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City | HAUPPAUGE
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State | NY
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Zip | 11788-5108
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Country | US
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Telephone | 631-260-2280
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Fax | 631-350-0570
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Provider Business Mailing Address
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Address Line | 150 MOTOR PKWY STE 401
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City | HAUPPAUGE
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State | NY
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Zip | 11788-5108
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Country | US
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Telephone | 631-260-2288
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Fax | 631-350-0570
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Authorized Official
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Title or Position | DOCTOR OF NURSE PRACTITIONER
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Name | DR. NICOLE LOUIS BEAUBRUN
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Credential | NP
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Telephone | 631-987-4989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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