Active NPI
Serenity Health & Wellness, LLC
- Family Nurse Practitioner
- Ketchikan, AK
National Provider Identifier
1639536394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 1383
- Legal business name
- SERENITY HEALTH & WELLNESS, LLC
- Practice address
- 120 Carlanna Lake Rd
Suite 102
Ketchikan, AK 99901-5611 - Phone
- (907) 247-9355
- NPI assigned
- Jan 25, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tammy Lorraine Earnest, FNP-C
- Title
- Owner/FNP
- Phone
- (907) 617-5453
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1383 | AK | Primary |
Addresses
Primary practice location
120 Carlanna Lake Rd
Suite 102
Ketchikan, AK 99901-5611
Mailing address
120 Carlanna Lake Rd
Suite 102
Ketchikan, AK 99901-5611
Phone (907) 247-9355
National Provider Directory
National Provider DirectoryLocations
120 Carlanna Lake Rd
Ste 1
Ketchikan, AK 99901
Phone (907) 247-9355
120 Carlanna Lake Rd
Ste 102
Ketchikan, AK 99901
Phone (907) 247-9355
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453680000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1453680000000",
"number": "1639536394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 CARLANNA LAKE RD",
"address_2": "SUITE 102",
"city": "KETCHIKAN",
"state": "AK",
"postal_code": "999015611",
"telephone_number": "907-247-9355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 CARLANNA LAKE RD",
"address_2": "SUITE 102",
"city": "KETCHIKAN",
"state": "AK",
"postal_code": "999015611",
"telephone_number": "907-247-9355"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SERENITY HEALTH & WELLNESS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2016-01-25",
"last_updated": "2016-01-25",
"status": "A",
"authorized_official_last_name": "EARNEST",
"authorized_official_first_name": "TAMMY",
"authorized_official_middle_name": "LORRAINE",
"authorized_official_title_or_position": "OWNER/FNP",
"authorized_official_telephone_number": "907-617-5453",
"authorized_official_credential": "FNP-C"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": "AK",
"license": "1383",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ketchikan, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.