Provider Demographics
NPI:1972163657
Name:NEHME, RENATA
Entity Type:Individual
Prefix:
First Name:RENATA
Middle Name:
Last Name:NEHME
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 1:122 LAKEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GUYTON
Mailing Address - State:GA
Mailing Address - Zip Code:31312-6561
Mailing Address - Country:US
Mailing Address - Phone:912-230-3553
Mailing Address - Fax:
Practice Address - Street 1:122 LAKEWOOD DR
Practice Address - Street 2:
Practice Address - City:GUYTON
Practice Address - State:GA
Practice Address - Zip Code:31312-6561
Practice Address - Country:US
Practice Address - Phone:912-230-3553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-16
Last Update Date:2019-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADH011107124Q00000X
172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist
No124Q00000XDental ProvidersDental Hygienist