| Doctor Name: | MS. RENEE LYNN JOHNSON KOTLARZ |
| NPI Number: | 1205166535 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHN |
| License Number: | R1378197 |
| Business Practice Address: | 1805 Ford Ave N Suite 200 Glencoe, MN - 553361363 |
| Business Phone Number: | 3208643185 |
| Business Fax Number: | |
| Mailing Address: | 1805 Ford Ave N, Suite 200 GLENCOE |
| State: | MN |
| Postal Code: | 553361363 |
| Phone Number: | 3208643185 |
| Fax Number: | 3208641484 |
| NPI Enumeration Date: | 01/08/2010 |
| NPI Last Update Date: | 04/25/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1500X |
| License Number: | R1378197 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |