Provider Demographics
NPI:1285026468
Name:RENFER, JESSICA (ND)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:RENFER
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 PUUEO ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-2429
Mailing Address - Country:US
Mailing Address - Phone:808-933-4325
Mailing Address - Fax:808-969-9350
Practice Address - Street 1:152 PUUEO ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2429
Practice Address - Country:US
Practice Address - Phone:808-933-4325
Practice Address - Fax:808-969-9350
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-25
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI267175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath