Individual
JAIME MARIE RENNECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2600 SIXTH ST SW, CANTON, OH 44710-1702
(330) 363-5433
(330) 363-7785
Mailing address
2600 6TH ST SW, CANTON, OH 44710-1702
(330) 363-5433
(330) 580-6785
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
APRN.CNP.019380
OH
Other
Enumeration date
04/16/2019
Last updated
07/08/2019
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