Provider Demographics
NPI:1649870817
Name:ATILANO, RENEE LYNN
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:LYNN
Last Name:ATILANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1986 PIZARRO LN
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92026-1741
Mailing Address - Country:US
Mailing Address - Phone:760-525-6237
Mailing Address - Fax:
Practice Address - Street 1:1986 PIZARRO LN
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92026-1741
Practice Address - Country:US
Practice Address - Phone:760-525-6237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN741536163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse