Provider Demographics
NPI:1063240117
Name:SERENE RESOLUTIONS LLC
Entity type:Organization
Organization Name:SERENE RESOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SOONDY
Authorized Official - Middle Name:R
Authorized Official - Last Name:JEGEDE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:386-235-0348
Mailing Address - Street 1:3 RIVER ROCK TRL
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-4957
Mailing Address - Country:US
Mailing Address - Phone:386-235-0348
Mailing Address - Fax:386-246-7418
Practice Address - Street 1:555 W GRANADA BLVD STE A7
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-9431
Practice Address - Country:US
Practice Address - Phone:386-235-0348
Practice Address - Fax:386-246-7418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-22
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty