Individual
LUCINDA MARIE RENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
310 N 10TH ST, BISMARCK, ND 58501-4516
(701) 530-7500
(701) 530-7484
Mailing address
310 N 10TH ST, BISMARCK, ND 58501-4516
(701) 530-7500
(701) 530-7484
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAC0181
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780757948
NPI
ND
01
—
31061
BCBSND
ND
Enumeration date
11/16/2006
Last updated
04/22/2009
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