SERENE LIFE LLC (NPI# 1912518853) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912518853 |
| Entity Type | Organization |
| Organization Name | SERENE LIFE LLC |
| Practice Address |
143 N Mccormick St Ste 103 Prescott AZ 86301-2725 |
| Mailing Address |
418 Isabelle Ln Prescott AZ 86301-6564 |
| Practice Telephone | 9288997784 |
| Mailing Telephone | 9288997784 |
| Mailing Fax Number | 6236982567 |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2020-08-13 |
| Authorized Official Name | INGE GISELA BUNDCHEN (PRESIDENT) |
| Authorized Official Telephone | 9288997784 |
| Authorized Official Credential | NP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
143 N MCCORMICK ST STE 103 |
| City | PRESCOTT |
| State | AZ |
| Zip Code | 86301-2725 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992787527 | Len Douglas Balke | Psychiatry & Neurology | 143 N Mccormick St Ste 103, Prescott, AZ 86301-2725 | 2005-11-18 |
| 1255954962 | Amy J Montgomery | Counselor | 143 N Mccormick St Ste 103, Prescott, AZ 86301-2725 | 2020-05-28 |
| 1801394184 | Serenity Psychiatric Health Inc. | Nurse Practitioner | 143 N Mccormick St Ste 103, Prescott, AZ 86301-2725 | 2018-02-01 |
| 1326163668 | Barbara J Swain | Psychologist | 143 N Mccormick St Ste 103, Prescott, AZ 86301-2725 | 2007-03-19 |
| 1194849422 | Barbara Swain, Phd, PC | Psychologist | 143 N Mccormick St Ste 103, Prescott, AZ 86301-2725 | 2007-03-19 |
| 1740357144 | Simone Maria Whitehead | Counselor | 143 N Mccormick St Ste 103, Prescott, AZ 86301-2725 | 2006-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102350 | Dove Marie Gundermann | Specialist/Technologist | 300 W. Gurley St, Prescott, AZ 86301 | 2020-07-30 |
| 1639712110 | Arizona Orthopedic Physical Therapy, Pllc | Clinic/Center | 1781 E State Highway 69, Suite 28, Prescott, AZ 86301 | 2019-10-28 |
| 1538714092 | Prescott Complete Care | Family Medicine | 1947 Commerce Center Circle, Suite A, Prescott, AZ 86301 | 2019-08-01 |
| 1336612571 | Sarah Elizabeth Elliott | Registered Nurse | 500 Az 89, Prescott, AZ 86301 | 2019-01-10 |
| 1912484270 | Asya Ruth Perkins | Counselor | 225 Grove Avenue, Prescott, AZ 86301 | 2018-07-19 |
| 1396241394 | Jerome Alexander Longoria | Chiropractor | 142 N. Rush St, Prescott, AZ 86301 | 2018-03-30 |
| 1619487675 | Yavapai Healthcare Group LLC | Nurse Practitioner | 999 Division Street, Prescott, AZ 86301 | 2017-10-04 |
| 1053835843 | United States Veterans Initiative | Counselor | 917 E Gurley St, Prescott, AZ 86301 | 2017-08-02 |
| 1164896999 | Spitler - Lilley, LLC | Hearing Instrument Specialist | 1781 E. State Rte 69, Suite 65, Prescott, AZ 86301 | 2015-11-17 |
| 1275925265 | Oral and Facial Surgery Center of Prescott | Dentist | 5415 Distiction Way, Prescott, AZ 86301 | 2015-02-27 |
| Find all providers in zip 86301 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801394184 | Serenity Psychiatric Health Inc. | Nurse Practitioner | 143 N Mccormick St Ste 103, Prescott, AZ 86301-2725 | 2018-02-01 |
| 1891095667 | Mary J Huff Psychiatric Nurse Practitioner Pllc | Nurse Practitioner | 143 N Mccormick St, Suite 103, Prescott, AZ 86301-2723 | 2010-10-27 |
| 1295783983 | Mary J. Huff | Nurse Practitioner | 143 N Mccormick St, Suite 103, Prescott, AZ 86301-2723 | 2006-05-04 |
| 1043217755 | Susan Elaine Spear | Nurse Practitioner | 1090 Commerce Dr, Prescott, AZ 86305 | 2005-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922608447 | Courtney Tafoya | Nurse Practitioner | 544 S 172nd Ave, Goodyear, AZ 85338-1281 | 2020-10-26 |
| 1215536479 | Yolanda D Baugh | Nurse Practitioner | 2625 W Piedmont Rd, Phoenix, AZ 85041-9540 | 2020-10-20 |
| 1871191593 | Lisa E Legg | Nurse Practitioner | 1480 E Pecos Rd Apt 3107, Gilbert, AZ 85295-1851 | 2020-10-14 |
| 1619584406 | Preston Strebeck | Nurse Practitioner | 3733 E Meadow Mist Ln, San Tan Valley, AZ 85140-5374 | 2020-09-25 |
| 1336754332 | Yvonne Maese | Nurse Practitioner | 824 N 99th Ave Ste 107-108, Avondale, AZ 85323-5324 | 2020-09-15 |
| 1306450960 | Williamsconsultant Com LLC | Nurse Practitioner | 2303 N 44th St Ste 12-1043, Phoenix, AZ 85008-2442 | 2020-09-01 |
| 1215549274 | Maria Graciela Cornejo | Nurse Practitioner | 3421 S Loback Ln, Gilbert, AZ 85297-7913 | 2020-08-20 |
| 1013529155 | Mark Skousen | Nurse Practitioner | 1745 W Western Dove Dr, Snowflake, AZ 85937-6185 | 2020-08-19 |
| 1356953699 | Rebecca Jane Turley | Nurse Practitioner | 1681 S Villas Ln, Chandler, AZ 85286-6805 | 2020-08-18 |
| 1467064063 | Dylan O'keefe Carey | Nurse Practitioner | 11702 W Fordson Dr, Marana, AZ 85653-7715 | 2020-08-17 |
| Find all providers with the same taxonomy | ||||
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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.