Provider Demographics
NPI:1013198530
Name:GARRETT, RENEE K (MHS, PA-C)
Entity Type:Individual
Prefix:MS
First Name:RENEE
Middle Name:K
Last Name:GARRETT
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Gender:F
Credentials:MHS, PA-C
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Mailing Address - Street 1:PO BOX 734905
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-4905
Mailing Address - Country:US
Mailing Address - Phone:904-449-7246
Mailing Address - Fax:904-719-7571
Practice Address - Street 1:4796 HODGES BLVD STE 101
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-2209
Practice Address - Country:US
Practice Address - Phone:904-449-7246
Practice Address - Fax:904-719-7571
Is Sole Proprietor?:No
Enumeration Date:2007-11-27
Last Update Date:2021-03-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9105431363AS0400X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical