Provider Demographics
NPI:1649229238
Name:RENS, ANN M (RN, BSN)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:RENS
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 SILVER CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-7047
Mailing Address - Country:US
Mailing Address - Phone:920-684-5940
Mailing Address - Fax:
Practice Address - Street 1:1315 SILVER CREEK RD
Practice Address - Street 2:
Practice Address - City:MANITOWOC
Practice Address - State:WI
Practice Address - Zip Code:54220-7047
Practice Address - Country:US
Practice Address - Phone:920-684-5940
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI88709-030163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health