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General NPI Number Information
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NPI Number | 1235043621
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Entity Type | Individual
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Provider Name | KERRY ANN RENNER RN
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Gender | Female
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Dates
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Enumeration Date | 10/01/2026
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Last Update Date | 10/01/2026
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Provider Practice Location Address
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Address Line | 100 HOSPITAL DR
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City | KETCHUM
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State | ID
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Zip | 83340
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Country | US
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Telephone | 208-726-5027
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Fax |
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Provider Business Mailing Address
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Address Line | 608 N 1ST AVE
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City | HAILEY
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State | ID
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Zip | 83333-7002
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Country | US
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Telephone | 208-721-7535
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WX0800X
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Taxonomy Name | Orthopedic Registered Nurse
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License Number | 36361
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License Number State | ID
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