Provider Demographics
NPI:1518662055
Name:RENAUD, ANDREE DAPHNEE (ARNP FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ANDREE
Middle Name:DAPHNEE
Last Name:RENAUD
Suffix:
Gender:F
Credentials:ARNP FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1688 NW 171ST AVE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1360
Mailing Address - Country:US
Mailing Address - Phone:954-614-2751
Mailing Address - Fax:
Practice Address - Street 1:1688 NW 171ST AVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1360
Practice Address - Country:US
Practice Address - Phone:954-614-2751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11024381363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily