Bodary, Renee L

Bodary, Renee L is an individual health care provider with primary practice located at 933 Newbury St , Fond Du Lac WI 54971-1730. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Bodary, Renee L can be contacted via phone (920) 748-0430.

Contact Information

Primary practice address
933 Newbury St Fond Du Lac WI 54971-1730
Phone: (920) 748-0430
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 3213-033 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 3213-33 Wisconsin

Profile Details

NPI number 1295922342
LBN Legal business name Bodary, Renee L
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 2nd, 2007
Last updated Mar 21st, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295922342 NPPES
Wisconsin Other 142231-030 RN
Wisconsin MEDICAID 36048500 RN

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