Kathleen R Renner, A.P.R.N.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

APRN11008064 Issued in FL

Practice address

4147 Southpoint Dr East
Optional
Jacksonville, FL 32216-3221

Phone

(904) 332-6774

Fax

(904) 661-0028

NPI assigned

Feb 26, 2021

Last updated

Feb 26, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1614297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1558955849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4147 SOUTHPOINT DR EAST",
            "address_2": "OPTIONAL",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32216",
            "telephone_number": "904-332-6774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4147 SOUTHPOINT DR EAST",
            "address_2": "OPTIONAL",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163221",
            "telephone_number": "904-332-6774",
            "fax_number": "904-661-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENNER",
        "first_name": "KATHLEEN",
        "middle_name": "R",
        "name_prefix": "Miss",
        "credential": "A.P.R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-26",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "APRN11008064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Briana Ashley-Rae Renfroe, APRN
• Raechel Renfrow
• Christopher Brian Renne, D.C.
• Kim Renne
• Anna Renner, PA-C
• Leticia B Reno, M.D.
• Kimberley Saft Rentschler, PHD, LCSW
• Shannon Rentz, OTR/L
• Renz Health Services, LLC
• Jon Michael Repole, D.C.

• Plastic Surgery Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Plastic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.