Individual
HEIDI HALE RENEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
100 S BLISS AVE, TAHLEQUAH, OK 74464-2512
(918) 458-3360
(918) 458-3511
Mailing address
100 S BLISS AVE, TAHLEQUAH, OK 74464-2512
(918) 458-3360
(918) 458-3511
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
101498
OK
367A00000X
Advanced Practice Midwife
64067
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200111380A
—
OK
Enumeration date
11/01/2006
Last updated
10/24/2012
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