Provider Demographics
NPI:1104201342
Name:RENTA, YVONNE (RN)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:
Last Name:RENTA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 MILL SPRINGS PL
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-3641
Mailing Address - Country:US
Mailing Address - Phone:205-566-6233
Mailing Address - Fax:
Practice Address - Street 1:825 MILL SPRINGS PL
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-3641
Practice Address - Country:US
Practice Address - Phone:205-566-6233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-048648163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse