| Doctor Name: | COLLEEN GRACE RENZI |
| NPI Number: | 1154740322 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | C0005337 |
| Business Practice Address: | 11601 Split Rail Ct North Bethesda, MD - 208524423 |
| Business Phone Number: | 3014675443 |
| Business Fax Number: | |
| Mailing Address: | 9901 Medical Center Dr, ROCKVILLE |
| State: | MD |
| Postal Code: | 208503357 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 04/15/2014 |
| NPI Last Update Date: | 04/15/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | C0005337 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |