MEDICARE: JESSICA RENTNER

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
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1881209104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA RENTNER

Provider Business Mailing Address
First Line	:	5620 FOX HOLLOW CT
Second Line	:
City	:	SYLVANIA
State	:	OH
Zip	:	43560-4214
Country	:	US
Telephone Number	:	419-349-8346
Fax Number	:

Provider Business Practice Location Address
First Line	:	2440 SOUTH AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43609-1611
Country	:	US
Telephone Number	:	419-276-5832
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2020
Last Update Date	:	09/14/2020

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