Provider Demographics
NPI:1295975217
Name:KINNEY, RENEE CORINNE (LPN)
Entity type:Individual
Prefix:MS
First Name:RENEE
Middle Name:CORINNE
Last Name:KINNEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53536-1018
Mailing Address - Country:US
Mailing Address - Phone:608-214-4520
Mailing Address - Fax:
Practice Address - Street 1:237 W MAIN ST
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:WI
Practice Address - Zip Code:53536-1018
Practice Address - Country:US
Practice Address - Phone:608-214-4520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI306675164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse