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General NPI Number Information
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NPI Number | 1508470519
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Entity Type | Individual
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Provider Name | MRS. YAN ZHAO RENNINGER
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Gender | Female
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Dates
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Enumeration Date | 09/07/2020
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 4488 W BROAD ST STE 3
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City | COLUMBUS
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State | OH
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Zip | 43228-5610
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Country | US
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Telephone | 614-453-1589
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Fax | 614-853-8570
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Provider Business Mailing Address
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Address Line | PO BOX 7527
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City | DUBLIN
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State | OH
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Zip | 43017-0727
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Country | US
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Telephone | 614-788-5400
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Fax | 614-788-5500
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.024600
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License Number State | OH
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