Individual
TANYA RENNIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, APRN
Contact information
Practice address
505 ST JAMES PL, NEWCASTLE, OK 73065-4082
(405) 387-2208
(405) 387-3430
Mailing address
505 ST JAMES PL, NEWCASTLE, OK 73065-4082
(405) 387-2208
(405) 387-3430
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R0105571
OK
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R0105571
OK
Other
Enumeration date
05/26/2015
Last updated
08/26/2021
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