Organization Active NPI

Serenity Health & Wellness, LLC

  • Family Nurse Practitioner
  • Ketchikan, AK
National Provider Identifier
1639536394
Registry record updated Jan 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1383 Issued in AK
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

Updated by the provider on Jan 25, 2016

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)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 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 Directory

Locations

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.

Verify at the official NPI Registry.