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General NPI Number Information
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NPI Number | 1912897083
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Entity Type | Organization
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Legal Business Name | ROYAL SERENITY HEALTHCARE, LLC
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Dates
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Enumeration Date | 07/08/2025
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 10573 CROSSBACK LN
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City | LEHIGH ACRES
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State | FL
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Zip | 33936-6682
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Country | US
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Telephone | 239-402-7439
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Fax | 239-230-2964
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Provider Business Mailing Address
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Address Line | 10573 CROSSBACK LN
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City | LEHIGH ACRES
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State | FL
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Zip | 33936-6682
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Country | US
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Telephone | 239-402-7439
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Fax | 239-230-2964
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Authorized Official
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Title or Position | APRN MSN FNP-BC PMHNP-BC
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Name | MRS. DANIELLE LASHAWN RUSSELL
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Credential |
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Telephone | 239-271-8280
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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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