SERENITY GYNECOLOGY LLC NPI 1295360949

NPI Information

  • NPI: 1295360949
  • Provider Name: SERENITY GYNECOLOGY, LLC
  • Classification: Obstetrics & Gynecology - 207VG0400X
  • Specialization: Gynecology
  • Entity Type: Organization
  • Former Legal Business Name: PREMIER WOMEN'S GYN, LLC
  • CLIA Number: 11D2185143
  • Address: 300 GLYNN STREET SOUTH
    FAYETTEVILLE, GA
    ZIP 30214
  • Phone: (770) 629-2702

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NPI Details

SERENITY GYNECOLOGY, LLC is a gynecology obstetrics gynecology in Fayetteville, GA. The provider is a physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee SERENITY GYNECOLOGY, LLC NPI is 1295360949. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Premier Women's Gyn, Llc.

The provider's business location address is:

300 GLYNN STREET SOUTH
FAYETTEVILLE, GA
ZIP 30214
Phone: (770) 629-2702
Fax: (770) 909-5004

The provider's authorized official is Tracey St. Julian .
The authorized official title is Physician Owner and has the following contact phone number (770) 629-2702.

The CLIA number assigned to this NPI record is 11D2185143 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/3/2020 and was last updated on 3/21/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207VG0400XObstetrics & GynecologyGynecologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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