Provider Demographics
NPI:1891806352
Name:NOVAK, RENEE LYNN (ARNP)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:LYNN
Last Name:NOVAK
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:LYNN
Other - Last Name:SCHMIEDL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2033 WOOD ST STE 220
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-7927
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2033 WOOD ST STE 220
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-7927
Practice Address - Country:US
Practice Address - Phone:941-677-3366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3292132363LF0000X, 363LP0808X
WAAP61116967363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAP61116967OtherAPRN
FL3292132OtherAPRN