Individual
MELISA KAYE RENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, MSN, FNP-C
Contact information
Practice address
6326 CONSTITUTION DR, FORT WAYNE, IN 46804-1518
(260) 515-3275
Mailing address
6326 CONSTITUTION DR, FORT WAYNE, IN 46804-1518
(260) 515-3275
(888) 803-6843
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71010644A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300047110
—
IN
Enumeration date
12/19/2007
Last updated
04/01/2021
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