Healthcare Provider Details

I. General information

NPI: 1285500017
Provider Name (Legal Business Name): RENEE RENEE REZNOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2025
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5494 GABRIELS LANDING DR
GALLOWAY OH
43119-8038
US

IV. Provider business mailing address

5494 GABRIELS LANDING DR
GALLOWAY OH
43119-8038
US

V. Phone/Fax

Practice location:
  • Phone: 614-271-0845
  • Fax:
Mailing address:
  • Phone: 614-271-0845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: