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Individual

MEGAN RENAUD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGPCNP

Contact information

Practice address
444 ROXBURY RD, ROCKFORD, IL 61107-5059
(815) 398-3000
Mailing address
726 LANAE WAY, SOUTH BELOIT, IL 61080-2524
(815) 997-4783

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209.028130
IL
363LG0600X
Gerontology Nurse Practitioner
Primary
209028130
IL
363LP2300X
Primary Care Nurse Practitioner
209028130
IL

Other

Enumeration date
09/01/2023
Last updated
10/11/2023
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