Provider Demographics
NPI:1689019051
Name:TELKER, RENEE ANNE (RN)
Entity Type:Individual
Prefix:MISS
First Name:RENEE
Middle Name:ANNE
Last Name:TELKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 ERIE AVE
Mailing Address - Street 2:
Mailing Address - City:CONNERSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47331-3176
Mailing Address - Country:US
Mailing Address - Phone:765-827-7890
Mailing Address - Fax:765-825-6628
Practice Address - Street 1:450 ERIE AVE
Practice Address - Street 2:
Practice Address - City:CONNERSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47331-3176
Practice Address - Country:US
Practice Address - Phone:765-827-7890
Practice Address - Fax:765-825-6628
Is Sole Proprietor?:No
Enumeration Date:2013-04-30
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28190730A163W00000X, 163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No163W00000XNursing Service ProvidersRegistered Nurse