Individual
MANDY KAY RENAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
13307 MIAMI LN, CALDWELL, ID 83607-4701
(208) 455-5345
(208) 454-7722
Mailing address
13307 MIAMI LN, CALDWELL, ID 83607-4701
(208) 455-5345
(208) 454-7722
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP1439A
ID
Other
Enumeration date
06/24/2014
Last updated
06/24/2014
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