Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | R1237063 | MN |
Y | 363LG0600X | Nurse Practitioner - Gerontology | R1237063 | MN |
NPI | 1023044484 |
---|---|
Provider Name | Renee K Doering |
First Address | Robbinsdale, MN 55422-2948 |
Second Address | Robbinsdale, MN 55422-2948 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2006 |
Last Update Date | 25/10/2010 |