Individual
RENEE LYNN DALLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
OPTUM CARE SERVICES COMPANY, 680 BLAIR MILL ROAD, PA 19044
(999) 999-9999
Mailing address
5101 HIGHLAND PARK AVE, ALTOONA, PA 16602-1440
(814) 935-1314
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
RN667379
PA
Other
Enumeration date
12/15/2023
Last updated
12/15/2023
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