Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | COA12677-NP | OH |
NPI | 1033492319 |
---|---|
Provider Name | Amy Gail Renner |
First Address | Akron, OH 44307-2433 |
Second Address | Akron, OH 44307-2433 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2011 |
Last Update Date | 23/09/2011 |