Provider Demographics
NPI:1801486956
Name:RENKEN, REGINA CHRISTINE
Entity type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:CHRISTINE
Last Name:RENKEN
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 1:5747 CINNAMON CT
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89433-6526
Mailing Address - Country:US
Mailing Address - Phone:903-259-0830
Mailing Address - Fax:775-686-6526
Practice Address - Street 1:1963 E PRATER WAY # 101
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89434-8938
Practice Address - Country:US
Practice Address - Phone:775-636-6269
Practice Address - Fax:775-686-6526
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide