Provider Demographics
NPI:1255086914
Name:PANEC, RENEE MARIE (RN)
Entity type:Individual
Prefix:MS
First Name:RENEE
Middle Name:MARIE
Last Name:PANEC
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5240 RESERVATION RD
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-9744
Mailing Address - Country:US
Mailing Address - Phone:530-409-9350
Mailing Address - Fax:
Practice Address - Street 1:5240 RESERVATION RD
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-9744
Practice Address - Country:US
Practice Address - Phone:530-409-9350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-21
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN402243171400000X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No171400000XOther Service ProvidersHealth & Wellness Coach