Healthcare Provider Details

I. General information

NPI: 1982820551
Provider Name (Legal Business Name): DEANNA RENZ DNP, CPNP, PMHNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3405 DALLAS HWY SW STE 300
MARIETTA GA
30064-6426
US

IV. Provider business mailing address

3405 DALLAS HWY SW STE 300
MARIETTA GA
30064-6426
US

V. Phone/Fax

Practice location:
  • Phone: 770-425-5331
  • Fax: 770-425-0799
Mailing address:
  • Phone: 770-425-5331
  • Fax: 770-425-0799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN104510
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN104510
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN104510
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: