Doctor Name: | TRACY A RENN |
NPI Number: | 1255409546 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-BC, ACNS-BC APNP |
License Number: | 2006008321-05 |
Business Practice Address: | 246 Tierney Dr New Richmond, WI - 540172515 |
Business Phone Number: | 7152462521 |
Business Fax Number: | 7152467977 |
Mailing Address: | 893 Willow River Dr, HUDSON |
State: | WI |
Postal Code: | 540166944 |
Phone Number: | 7152467895 |
Fax Number: | |
NPI Enumeration Date: | 12/04/2006 |
NPI Last Update Date: | 09/07/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 364SA2200X |
License Number: | 2006008321-05 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Clinical Nurse Specialist |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |