Provider Demographics
NPI:1730535329
Name:XSERENITY, QUENNIE (MSN, RN)
Entity type:Individual
Prefix:MISS
First Name:QUENNIE
Middle Name:
Last Name:XSERENITY
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:MISS
Other - First Name:QUENNIE
Other - Middle Name:LANADA
Other - Last Name:BONNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6555 MEMPHIS AVE
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32526-9077
Mailing Address - Country:US
Mailing Address - Phone:850-285-9872
Mailing Address - Fax:
Practice Address - Street 1:3224 MARINERS DR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32526-2572
Practice Address - Country:US
Practice Address - Phone:850-281-5443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-12
Last Update Date:2025-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9469399163W00000X
HIRN79501163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse