Provider Demographics
NPI:1659537660
Name:RENEGAR, NANCY M
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:M
Last Name:RENEGAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:JANE
Other - Last Name:MCCLUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:885 KEMPSVILLE RD STE 221
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3800
Mailing Address - Country:US
Mailing Address - Phone:757-623-0526
Mailing Address - Fax:757-623-0609
Practice Address - Street 1:885 KEMPSVILLE RD STE 221
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3800
Practice Address - Country:US
Practice Address - Phone:757-623-0526
Practice Address - Fax:757-623-0609
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201000408231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist