Healthcare Provider Details

I. General information

NPI: 1760838163
Provider Name (Legal Business Name): JEANNIE-KAY NERENBURG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2016
Last Update Date: 05/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 S MAIN ST
SALINAS CA
93901-2260
US

IV. Provider business mailing address

57293 JOLON RD
KING CITY CA
93930-9689
US

V. Phone/Fax

Practice location:
  • Phone: 831-422-7777
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number346937
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number1278
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: