Provider Demographics
NPI:1013090455
Name:RENCH, JENNIFER ANN-GABRYS (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ANN-GABRYS
Last Name:RENCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 WALTON DR
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:WI
Mailing Address - Zip Code:53073-5022
Mailing Address - Country:US
Mailing Address - Phone:920-496-4700
Mailing Address - Fax:
Practice Address - Street 1:825 WALTON DR
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:WI
Practice Address - Zip Code:53073-5022
Practice Address - Country:US
Practice Address - Phone:920-893-4322
Practice Address - Fax:920-893-9506
Is Sole Proprietor?:No
Enumeration Date:2006-10-21
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1734207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine