Healthcare Provider Details

I. General information

NPI: 1366864118
Provider Name (Legal Business Name): DAWN RENSHAW PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2014
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

847 W CHILDS AVE
MERCED CA
95341-6862
US

IV. Provider business mailing address

7373 HUSKER CIR APT 309
LINCOLN NE
68504-3915
US

V. Phone/Fax

Practice location:
  • Phone: 402-840-8179
  • Fax:
Mailing address:
  • Phone: 402-840-8179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number95026281
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number111447
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95268460
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number74823
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: