Healthcare Provider Details

I. General information

NPI: 1528595162
Provider Name (Legal Business Name): RENEE SCHENNING CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2017
Last Update Date: 07/21/2024
Certification Date: 07/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 S HANOVER ST
BALTIMORE MD
21225-1233
US

IV. Provider business mailing address

6221 GREENLEIGH AVE UNIT 324
BALTIMORE MD
21220-2019
US

V. Phone/Fax

Practice location:
  • Phone: 410-350-3200
  • Fax:
Mailing address:
  • Phone: 410-790-9896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR149427
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR149427
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberR149427
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: