Provider Demographics
NPI:1114562675
Name:DANNER, RENEE (RD)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:DANNER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 BOXWOOD CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-8260
Mailing Address - Country:US
Mailing Address - Phone:507-405-2013
Mailing Address - Fax:
Practice Address - Street 1:590 PETER JEFFERSON PKWY STE 175
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-4655
Practice Address - Country:US
Practice Address - Phone:434-465-9358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-08
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date: