Provider Demographics
NPI:1053075648
Name:NEUENS, RENEE MCGUIRE (RN, BSN, IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:MCGUIRE
Last Name:NEUENS
Suffix:
Gender:F
Credentials:RN, BSN, IBCLC
Other - Prefix:MISS
Other - First Name:RENEE
Other - Middle Name:MCGUIRE
Other - Last Name:HALKERSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:106 HOLLY CT
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21666-3348
Mailing Address - Country:US
Mailing Address - Phone:301-466-1142
Mailing Address - Fax:
Practice Address - Street 1:165 LOG CANOE CIRCLE SUITE E
Practice Address - Street 2:165 LOG CANOE CIRCLE SUITE E
Practice Address - City:STEVENSVLLE
Practice Address - State:MD
Practice Address - Zip Code:21666-2149
Practice Address - Country:US
Practice Address - Phone:301-466-1142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR107703163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant