Mesack, Renee Deanne

Mesack, Renee Deanne is an individual health care provider with primary practice located at 1996 Walden Dr , Gaylord MI 49735-8241. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Mesack, Renee Deanne can be contacted via phone (989) 731-4111.

Contact Information

Primary practice address
1996 Walden Dr Gaylord MI 49735-8241
Phone: (989) 731-4111
Fax: (989) 705-8511
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 5601002853 Michigan

Profile Details

NPI number 1629005111
LBN Legal business name Mesack, Renee Deanne
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 28th, 2006
Last updated Dec 3rd, 2013 - 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 1629005111 NPPES
Other 381303843 TAX ID
Other OF96004 TAX ID

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