Individual
AMANDA S RENNIE
Active
Individual
AMANDA S RENNIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28250897A
IN
363L00000X
Nurse Practitioner
71014562A
IN
363LA2100X
Acute Care Nurse Practitioner
Primary
71014562A
IN
Other
Enumeration date
10/16/2023
Last updated
11/22/2023
Update your record
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