Healthcare Provider Details

I. General information

NPI: 1811534282
Provider Name (Legal Business Name): OLIVIA KAYE RENDER CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2019
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S CLEVELAND MASSILLON RD STE 1
FAIRLAWN OH
44333-9204
US

IV. Provider business mailing address

1000 S CLEVELAND MASSILLON RD STE 1
FAIRLAWN OH
44333-9204
US

V. Phone/Fax

Practice location:
  • Phone: 330-754-4844
  • Fax: 833-974-2062
Mailing address:
  • Phone: 330-754-4844
  • Fax: 833-974-2062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0043523
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.435846
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN.435846
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: