Provider Demographics
NPI:1134641129
Name:GAUAMIS, RENELLA ALCARAZ (APRN,CNP)
Entity Type:Individual
Prefix:
First Name:RENELLA
Middle Name:ALCARAZ
Last Name:GAUAMIS
Suffix:
Gender:F
Credentials:APRN,CNP
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:5757 MONCLOVA RD
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1863
Mailing Address - Country:US
Mailing Address - Phone:419-897-8417
Mailing Address - Fax:419-897-8411
Practice Address - Street 1:5757 MONCLOVA RD
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-1863
Practice Address - Country:US
Practice Address - Phone:419-897-8417
Practice Address - Fax:418-897-8411
Is Sole Proprietor?:No
Enumeration Date:2017-07-11
Last Update Date:2017-07-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.021219207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine