Provider Demographics
NPI:1326531492
Name:RENKO, SARAH ANN NICOLE (APRN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN NICOLE
Last Name:RENKO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 LONGVIEW DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-2232
Mailing Address - Country:US
Mailing Address - Phone:740-503-0336
Mailing Address - Fax:
Practice Address - Street 1:235 BOGGS LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2584
Practice Address - Country:US
Practice Address - Phone:859-376-1363
Practice Address - Fax:859-376-1326
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH023089363LF0000X
KY4003564363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily