Provider Demographics
NPI:1770829467
Name:KERN, RENEE LYN (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:LYN
Last Name:KERN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2252 W CHIPPEWA RIVER RD
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-9127
Mailing Address - Country:US
Mailing Address - Phone:989-430-4608
Mailing Address - Fax:
Practice Address - Street 1:4599 JENNIFER LN
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-2064
Practice Address - Country:US
Practice Address - Phone:989-317-4762
Practice Address - Fax:989-317-4766
Is Sole Proprietor?:No
Enumeration Date:2012-12-27
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704242689363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily