Provider Demographics
NPI:1184179434
Name:WEGNER, RENEE (DOULA -CD (DONA))
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:
Last Name:WEGNER
Suffix:
Gender:F
Credentials:DOULA -CD (DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58236 ANACONDA DR
Mailing Address - Street 2:
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92284-6104
Mailing Address - Country:US
Mailing Address - Phone:760-895-8877
Mailing Address - Fax:
Practice Address - Street 1:58236 ANACONDA DR
Practice Address - Street 2:
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-6104
Practice Address - Country:US
Practice Address - Phone:760-895-8877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula