Provider Demographics
NPI:1356195382
Name:FLETCHER, RENA SHEMA (FNP)
Entity type:Individual
Prefix:MISS
First Name:RENA
Middle Name:SHEMA
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 WESTSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:HAVERSTRAW
Mailing Address - State:NY
Mailing Address - Zip Code:10927-1214
Mailing Address - Country:US
Mailing Address - Phone:585-270-9384
Mailing Address - Fax:
Practice Address - Street 1:3400 BAINBRIDGE AVE FL 7
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2404
Practice Address - Country:US
Practice Address - Phone:718-920-2626
Practice Address - Fax:718-652-1833
Is Sole Proprietor?:No
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF353671-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily