| Serenity Family Practice | |
|
1661 E Flamingo Rd Ste 5a Las Vegas NV 89119-5291 | |
| (702) 734-0770 | |
| (702) 734-0837 |
| Full Name | Serenity Family Practice |
|---|---|
| Speciality | Clinic/Center |
| Location | 1661 E Flamingo Rd Ste 5a, Las Vegas, Nevada |
| Authorized Official Name and Position | Pamela Winn (OWNER) |
| Authorized Official Contact | 7024278554 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Serenity Family Practice 1661 E Flamingo Rd Ste 5a Las Vegas NV 89119-5291 Ph: () - | Serenity Family Practice 1661 E Flamingo Rd Ste 5a Las Vegas NV 89119-5291 Ph: (702) 734-0770 |
| NPI Number | 1598220998 |
|---|---|
| Provider Enumeration Date | 02/10/2019 |
| Last Update Date | 11/13/2020 |
| Medicare PECOS PAC ID | 0345587044 |
|---|---|
| Medicare Enrollment ID | O20190201001826 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598220998 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Vy Ong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538623822 PECOS PAC ID: 9335578368 Enrollment ID: I20200326002038 |
| Provider Name | Tanya Lauren Cavanaugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841812278 PECOS PAC ID: 5092126227 Enrollment ID: I20201119001760 |
| Provider Name | Jibran Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629790423 PECOS PAC ID: 5395118038 Enrollment ID: I20230228003232 |
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