Individual
TERESA ANN RENNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
3314 VANDENBERG RD, KLAMATH FALLS, OR 97603-3730
(541) 882-7291
(541) 883-4213
Mailing address
3314 VANDENBERG RD, KLAMATH FALLS, OR 97603-3730
(541) 882-7291
(541) 883-4213
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
OOO32868
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100315
—
OR
Enumeration date
05/15/2007
Last updated
07/09/2007
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