Provider Demographics
NPI:1700368214
Name:FIORENTINO, RENEE
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:FIORENTINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 COMMERCE ST STE 700
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37201-1835
Mailing Address - Country:US
Mailing Address - Phone:615-454-9850
Mailing Address - Fax:
Practice Address - Street 1:1000 N WEST ST STE 1200
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-1058
Practice Address - Country:US
Practice Address - Phone:302-613-2493
Practice Address - Fax:855-737-5542
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0001213363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily