Renneberg, Jacquelyn
Renneberg, Jacquelyn is an sole proprietor health care provider with primary practice located at 17201 I H 45 S , Shenandoah TX 77385-3311. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as her primary health care specialty. Renneberg, Jacquelyn can be contacted via phone (936) 270-2099.Contact Information
Primary practice address
17201 I H 45 S
Shenandoah TX 77385-3311
Phone: (936) 270-2099
Fax: (713) 790-8703
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Acute Care | 363LA2100X | AP136074 | Texas |
Profile Details
| NPI number | 1275048118 |
|---|---|
| LBN Legal business name | Renneberg, Jacquelyn |
| Credentials | Advanced Practice Registered Nurse (APRN) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 13th, 2017 |
| Last updated | Apr 17th, 2018 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275048118 | NPPES |
| Texas | MEDICAID | 380656401 |
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