Renner, Heath Russell

Renner, Heath Russell is an sole proprietor health care provider with primary practice located at 3366 Oakdale Ave N Suite 103, Robbinsdale MN 55422-2948. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Renner, Heath Russell can be contacted via phone (763) 520-7870.

Contact Information

Primary practice address
3366 Oakdale Ave N Suite 103 Robbinsdale MN 55422-2948
Phone: (763) 520-7870
Fax: (763) 520-7580
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 9757 Minnesota

Profile Details

NPI number 1285645044
LBN Legal business name Renner, Heath Russell
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 10th, 2006
Last updated Jul 11th, 2007 - about 18 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 1285645044 NPPES
Other 969991033651 PREFERREDONE
Other 065G8RE PREFERREDONE
Other 116980 PREFERREDONE
Other 13138C564 PREFERREDONE
Other HP39821 PREFERREDONE

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