Basic Information
| Provider Information | |||||||||
| NPI: | 1134858897 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SEEKING SERENITY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1925 BEXLEY LN | ||||||||
| Address2: | |||||||||
| City: | CHESAPEAKE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 233224443 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7574533822 | ||||||||
| FaxNumber: | 7574534753 | ||||||||
| Practice Location | |||||||||
| Address1: | 1545 CROSSWAYS BLVD STE 250 | ||||||||
| Address2: | |||||||||
| City: | CHESAPEAKE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 233200218 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7574533822 | ||||||||
| FaxNumber: | 7577574534 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2022 | ||||||||
| LastUpdateDate: | 06/14/2022 | ||||||||
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| AuthorizedOfficialLastName: | GREENIDGE | ||||||||
| AuthorizedOfficialFirstName: | DEBBIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | NP | ||||||||
| AuthorizedOfficialTelephone: | 7574533822 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MISS | ||||||||
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| AuthorizedOfficialCredential: | NURSE PRACTITIONER | ||||||||
| NPICertificationDate: | 06/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.