Individual
CHARITY RENTERIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8135 CALUMET AVE, MUNSTER, IN 46321-1701
(219) 513-2000
Mailing address
1923 W GLEN PARK AVE, GRIFFITH, IN 46319-3703
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2021184121
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20211841212
—
IN
Enumeration date
05/06/2022
Last updated
05/06/2022
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