Organization
SERENITY HEALTH CARE CENTER SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA MUTH NP (PRESIDENT)
(414) 840-9817
Entity
Organization
Contact information
Practice address
2607 N GRANDVIEW BLVD, WAUKESHA, WI 53188-1686
(262) 522-8640
Mailing address
2607 N GRANDVIEW BLVD, WAUKESHA, WI 53188-1686
(262) 522-8640
Taxonomy
Speciality
Code
Description
License number
State
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
14469
WI
363LW0102X
Women's Health Nurse Practitioner
Primary
1167
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1912089228
NPI
WI
Enumeration date
12/03/2010
Last updated
01/06/2016
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