MEDICARE: SERENA HULSEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	338418	AZ

General Provider Information

NPI Number	:	1356287601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SERENA HULSEY

Provider Business Mailing Address
First Line	:	24412 N 40TH AVE
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85310-3271
Country	:	US
Telephone Number	:	928-699-3916
Fax Number	:

Provider Business Practice Location Address
First Line	:	3404 W CHERYL DR STE A150
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85051-9615
Country	:	US
Telephone Number	:	602-510-6582
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2026
Last Update Date	:	04/28/2026

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Directions to “ SERENA HULSEY ” Practice Location

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