Provider Demographics
NPI:1841322047
Name:BARNETT, RENAE MICHELE (RD,LDN)
Entity type:Individual
Prefix:MRS
First Name:RENAE
Middle Name:MICHELE
Last Name:BARNETT
Suffix:
Gender:F
Credentials:RD,LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11416 PIPING ROCK DR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-1634
Mailing Address - Country:US
Mailing Address - Phone:561-324-5623
Mailing Address - Fax:561-736-6399
Practice Address - Street 1:11416 PIPING ROCK DR
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-1634
Practice Address - Country:US
Practice Address - Phone:561-324-5623
Practice Address - Fax:561-736-6399
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND3983133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE8349Medicare ID - Type Unspecified