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General NPI Number Information
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NPI Number | 1922974773
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Entity Type | Organization
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Legal Business Name | SERENITY HEALTHY MINDS AND TELEMEDICINE WELLNESS LLC
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Dates
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Enumeration Date | 10/16/2025
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 20948 E STARFLOWER DR
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-2413
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Country | US
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Telephone | 480-508-0774
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Fax | 480-508-0768
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Provider Business Mailing Address
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Address Line | 24871 S ELLSWORTH RD STE 100
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-1575
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Country | US
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Telephone | 480-593-3563
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Fax |
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Authorized Official
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Title or Position | PMHNP/OWNER
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Name | ETHEL OLUYEMISI WINFUNKE-ROCHIN
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Credential |
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Telephone | 480-508-0774
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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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