SERENITY HEALTH CARE CENTER SC (NPI# 1770885220) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1770885220 |
Entity Type | Organization |
Organization Name | SERENITY HEALTH CARE CENTER SC |
Practice Address |
2607 N Grandview Blvd Waukesha WI 53188-1686 |
Practice Telephone | 2625228640 |
Mailing Telephone | 2625228640 |
Enumeration Date | 2010-12-03 |
Last Update Date | 2016-01-06 |
Authorized Official Name | DEBRA MUTH (PRESIDENT) |
Authorized Official Telephone | 4148409817 |
Authorized Official Credential | NP |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207RA0201X |
Internal Medicine Specialization: Allergy & Immunology |
14469 | WI | Allopathic & Osteopathic Physicians |
Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
1167 | WI | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WI | NPI | 1912089228 | 01 |
Street Address |
2607 N GRANDVIEW BLVD |
City | WAUKESHA |
State | WI |
Zip Code | 53188-1686 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326031964 | Bradley Theodore John Straka | Dermatology | 2607 N Grandview Blvd, Ste 125, Waukesha, WI 53188-1686 | 2005-08-30 |
1508409806 | Kendra Bittner | Counselor | 2607 N Grandview Blvd, Waukesha, WI 53188-1686 | 2019-10-21 |
1790216554 | Highlander Dermatology LLC | Clinic/Center | 2607 N Grandview Blvd, Ste 125, Waukesha, WI 53188-1686 | 2017-03-23 |
1134650302 | Michael Richard Gissibl | Counselor | 2607 N Grandview Blvd, Suite 110, Waukesha, WI 53188-1686 | 2017-03-21 |
1174975411 | Midwest Natural Healing | Chiropractor | 2607 N Grandview Blvd, Waukesha, WI 53188-1686 | 2016-07-11 |
1245680081 | Debra Sarnowski | Counselor | 2607 N Grandview Blvd, Suite 110, Waukesha, WI 53188-1686 | 2016-06-13 |
1750741013 | Nicole Flannery | Counselor | 2607 N Grandview Blvd, #110, Waukesha, WI 53188-1686 | 2016-03-01 |
1902208283 | Amy Hoffman | Nurse Practitioner | 2607 N Grandview Blvd, Suite 150, Waukesha, WI 53188-1686 | 2014-09-18 |
1386051472 | Jessica Niedermayer | Counselor | 2607 N Grandview Blvd, Suite 108, Waukesha, WI 53188-1686 | 2014-07-21 |
1043633159 | Gary Swan | Counselor | 2607 N Grandview Blvd, Suite 104, Waukesha, WI 53188-1686 | 2014-01-24 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336787126 | Nicole Lee Berg-johnson | Nurse Practitioner | 820 Crestwood Dr., Waukesha, WI 53188 | 2019-12-12 |
1013475706 | Rachel Mueller | Occupational Therapist | 29667 Summit Ave, S11, Waukesha, WI 53188 | 2019-03-12 |
1861962649 | Emily Elizabeth Seefeld | Occupational Therapy Assistant | 29667 Summit Ave S11, Waukesha, WI 53188 | 2018-12-05 |
1003393307 | Ashley Susan Callahan | Dental Hygienist | 711 W. Moreland Blvd., Suite 204, Waukesha, WI 53188 | 2018-07-19 |
1245741321 | Melissa Weir | Case Manager/Care Coordinator | 514 Riverview Avenue, Waukesha, WI 53188 | 2017-10-17 |
1093233629 | Patricia Marie Sombrio | Dental Hygienist | 711 Moreland Blvd 204, Waukesha, WI 53188 | 2017-09-04 |
1134660244 | Bdg of Wisconsin, Inc. | Behavioral Analyst | N19w2309 Riverwood Drive, Suite 350 Pmb 314, Waukesha, WI 53188 | 2017-03-09 |
1255888731 | Lynne Sarah Alva | Dental Hygienist | 711 Moreland Blvd, Suite 204, Waukesha, WI 53188 | 2016-09-01 |
1881069730 | Michelle Koch | Occupational Therapist | 29667 Summit Ave. S11, Waukesha, WI 53188 | 2015-12-03 |
1952711012 | Rhonda Schroeder | Dental Hygienist | W286 N991 Shepherds Way, Waukesha, WI 53188 | 2014-04-29 |
Find all providers in zip 53188 |
Taxonomy Code | 363LW0102X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Women's Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619992732 | Debra A Muth | Nurse Practitioner | 2607 N Grandview Blvd Ste 150, Waukesha, WI 53188-1686 | 2006-07-12 |
1124186234 | Betty Jean Kreuziger | Nurse Practitioner | 725 American Ave, Waukesha, WI 53188-5031 | 2006-12-04 |
1891785754 | Kim Marie Henrichs | Nurse Practitioner | 20611 Watertown Rd, Waukesha, WI 53186-1871 | 2005-10-24 |
1417946492 | Kathryn Marie Daly | Nurse Practitioner | 20611 Watertown Rd, Waukesha, WI 53186-1871 | 2005-10-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477103570 | Denyse F Jackson | Nurse Practitioner | 65 S Elm St, Platteville, WI 53818-3107 | 2019-09-19 |
1043668528 | Linda Helen Watson | Nurse Practitioner | 1828 E Main St, Suite 10, Onalaska, WI 54650-8780 | 2016-05-25 |
1033447594 | Wise Woman Wellness LLC | Nurse Practitioner | 1480 Swan Rd, De Pere, WI 54115-7966 | 2009-11-20 |
1457585721 | Laura Elizabeth Kwitek | Nurse Practitioner | 5543 E. Cheryl Parkway, Fitchburg, WI 53711 | 2009-05-14 |
1326210626 | Diane Marie Rundle | Nurse Practitioner | 96 Stoddart St, Beaver Dam, WI 53916-1306 | 2008-03-26 |
1730381401 | Margaret Mary Robertson | Nurse Practitioner | 3706 Orin Road, Madison, WI 53704 | 2007-06-04 |
1194939918 | Deirdre Vyvyan Fowler | Nurse Practitioner | 1710 S 7th St, Milwaukee, WI 53204-3538 | 2007-05-10 |
1194848903 | Britt Lapreil Wanta | Nurse Practitioner | 416 W Mifflin St, Madison, WI 53703-2502 | 2007-04-08 |
1538202262 | Pamela Charlene Prince | Nurse Practitioner | 949 N 9th St, Health Services Unit, Milwaukee, WI 53233-1422 | 2007-02-14 |
1568508695 | Donna Lee Hays | Nurse Practitioner | 1015 Burbank Ave, Janesville, WI 53546-6154 | 2007-01-29 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.