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General NPI Number Information
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NPI Number | 1740661503
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Entity Type | Individual
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Provider Name | JENNA RENNELLS PMHNP-BC, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/17/2015
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Last Update Date | 03/27/2024
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Provider Practice Location Address
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Address Line | 104 W EXCHANGE ST
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City | OWOSSO
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State | MI
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Zip | 48867-2816
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Country | US
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Telephone | 989-675-7910
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Fax |
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Provider Business Mailing Address
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Address Line | 8078 HOLLISTER RD
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City | LAINGSBURG
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State | MI
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Zip | 48848-9230
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Country | US
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Telephone | 517-420-3829
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4704285908
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 4704285908
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License Number State | MI
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