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General NPI Number Information
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NPI Number | 1669365466
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Entity Type | Individual
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Provider Name | VALERIE LOPEZ RENNON NP RN
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Gender | Female
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 44575 GARFIELD RD
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-1139
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Country | US
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Telephone | 586-445-7999
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Fax |
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Provider Business Mailing Address
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Address Line | 34317 DANTE DR
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City | CHESTERFIELD
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State | MI
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Zip | 48047-3286
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Country | US
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Telephone | 972-998-3641
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 104756825
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704366316
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License Number State | MI
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