Individual
JACQUELYN RENNEBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
17201 I H 45 S, SHENANDOAH, TX 77385-3311
(936) 270-2099
(713) 790-8703
Mailing address
17201 I H 45 S, SHENANDOAH, TX 77385-3311
(936) 270-2099
(713) 790-8703
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP136074
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
380656401
—
TX
Enumeration date
12/13/2017
Last updated
04/17/2018
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