SERENITY HEALTH CARE CENTER SC NPI 1770885220

NPI Information

NPI: 1770885220
Provider Name: SERENITY HEALTH CARE CENTER SC
Classification: Nurse Practitioner - 363LW0102X
Entity Type: Organization

Specialization: Women's Health

CLIA Number: 52D2018679

Address:
2607 N GRANDVIEW BLVD
WAUKESHA, WI
ZIP 53188
Phone: (262) 522-8640
Get Directions

SERENITY HEALTH CARE CENTER SC is a women's health nurse practitioner in Waukesha, WI. SERENITY HEALTH CARE CENTER SC NPI is 1770885220. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2607 N GRANDVIEW BLVD
WAUKESHA, WI
ZIP 53188-686
Phone: (262) 522-8640

The provider's authorized official is Debra Muth .
The authorized official title is President and has the following contact phone number (414) 840-9817.

The CLIA number assigned to this NPI record is 52D2018679 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/3/2010 and was last updated on 1/6/2016.

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
1	207RA0201X	Internal Medicine	Allergy & Immunology	14469	WISCONSIN	No
2	363LW0102X	Nurse Practitioner	Women's Health	1167	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	W12191	MEDICARE PIN	WISCONSIN
2	351773	MEDICARE UPIN	WISCONSIN
3	1912089228	OTHER	WISCONSIN	NPI

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: 4/28/2024

NPI Synchronization or Removal

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