Provider Demographics
NPI:1790377141
Name:RENAUD, CHAUN JANELLE (BS)
Entity Type:Individual
Prefix:
First Name:CHAUN
Middle Name:JANELLE
Last Name:RENAUD
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:CHAUNTEE
Other - Middle Name:
Other - Last Name:ROWLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15 CEDAR ST APT 2R
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-3311
Mailing Address - Country:US
Mailing Address - Phone:617-507-9616
Mailing Address - Fax:
Practice Address - Street 1:7455 W WASHINGTON AVE STE 302
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-4340
Practice Address - Country:US
Practice Address - Phone:855-864-4322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZA2600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherArt, Medical