Provider Demographics
NPI:1790241529
Name:ISENHOUR, RENOTA STRICKLAND (LPN)
Entity Type:Individual
Prefix:
First Name:RENOTA
Middle Name:STRICKLAND
Last Name:ISENHOUR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1895 E DIXON BLVD
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28152-6901
Mailing Address - Country:US
Mailing Address - Phone:704-466-3970
Mailing Address - Fax:704-600-6011
Practice Address - Street 1:1895 E DIXON BLVD
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28152-6901
Practice Address - Country:US
Practice Address - Phone:704-466-3970
Practice Address - Fax:704-600-6011
Is Sole Proprietor?:No
Enumeration Date:2019-02-18
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC67847164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse