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NPI Code Detail

MEDICARE: MEGAN LARAE RENNER FNP-C

MEDICARE:   MEGAN LARAE RENNER  FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner115568NE

General Provider Information

NPI Number : 1053143065
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN LARAE RENNER FNP-C
Provider Business Mailing Address
First Line : 302 S JEFFERS ST
Second Line :
City : NORTH PLATTE
State : NE
Zip : 69101-5349
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 302 S JEFFERS ST
Second Line :
City : NORTH PLATTE
State : NE
Zip : 69101-5349
Country : US
Telephone Number : 308-534-6687
Fax Number : 308-534-1874
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2024
Last Update Date : 09/12/2024

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Directions to “ MEGAN LARAE RENNER FNP-C” Practice Location

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