Individual
MRS. RENEE LYNN VANDEN AVOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
525 ROBERT ST S, PIERZ, MN 56364-7158
(218) 838-8408
Mailing address
525 ROBERT ST S, PIERZ, MN 56364-7158
(218) 838-8408
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
1110841
MN
374U00000X
Home Health Aide
256577
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1110841
AFC LICENSE
MN
01
—
1111492
BACKGROUND STUDY
MN
01
—
256577
VENDOR NUMBER
MN
Enumeration date
10/26/2021
Last updated
12/02/2021
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