Healthcare Provider Details

I. General information

NPI: 1699566190
Provider Name (Legal Business Name): RENEE COLLETTE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2025
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 MAC COVE DR
FRANKLIN NC
28734-0448
US

IV. Provider business mailing address

95 MAC COVE DR
FRANKLIN NC
28734-0448
US

V. Phone/Fax

Practice location:
  • Phone: 828-380-9380
  • Fax: 828-380-9380
Mailing address:
  • Phone: 828-380-9380
  • Fax: 828-380-9380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1600X
TaxonomyContinuing Education/Staff Development Registered Nurse
License Number161832
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: