Provider Demographics
NPI:1700440898
Name:SUMTER, RENEE
Entity Type:Individual
Prefix:MISS
First Name:RENEE
Middle Name:
Last Name:SUMTER
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 1:803 MORISSETTE WAY
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-7329
Mailing Address - Country:US
Mailing Address - Phone:707-450-9823
Mailing Address - Fax:
Practice Address - Street 1:803 MORISSETTE WAY
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-7329
Practice Address - Country:US
Practice Address - Phone:707-450-9823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-24
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)