JACQUELYN RENNEBERG (NPI# 1275048118) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275048118 |
| Entity Type | Individual |
| Full Name | JACQUELYN RENNEBERG |
| Credential | APRN |
| Practice Address |
17201 I H 45 S Shenandoah TX 77385-3311 |
| Practice Telephone | 9362702099 |
| Practice Fax Number | 7137908703 |
| Mailing Telephone | 9362702099 |
| Mailing Fax Number | 7137908703 |
| Enumeration Date | 2017-12-13 |
| Last Update Date | 2018-04-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
AP136074 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 380656401 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 9250 Pinecroft Dr, Shenandoah, TX 773803218 | 7138972300 |
| Street Address |
17201 I H 45 S |
| City | SHENANDOAH |
| State | TX |
| Zip Code | 77385-3311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265438519 | Marcus Darnell Smith Sr. | Internal Medicine | 17201 I H 45 S, Shenandoah, TX 77385-3311 | 2005-06-22 |
| 1447881552 | Kimberly Ann Quinn | Nurse Practitioner | 17201 I H 45 S, Shenandoah, TX 77385-3311 | 2020-01-28 |
| 1215313267 | Noreen Kane | Nurse Practitioner | 17201 I H 45 S, Shenandoah, TX 77385 | 2015-07-31 |
| 1992146328 | Sydney Anne Richards | Nurse Practitioner | 17201 I H 45 S, Shenandoah, TX 77385-3311 | 2013-07-14 |
| 1578826582 | Leyla Mehdinasab | Internal Medicine | 17201 I H 45 S, Shenandoah, TX 77385 | 2012-06-25 |
| 1477794675 | James Robert Quigley I | Registered Nurse | 17201 I H 45 S, Shenandoah, TX 77385-3311 | 2009-03-18 |
| 1578739629 | Justin Douglas Rice | Internal Medicine | 17201 I H 45 S, Shenandoah, TX 77385-3311 | 2008-05-07 |
| 1205011053 | Kathryn L Kelley | Nurse Practitioner | 17201 I H 45 S, Shenandoah, TX 77385-3311 | 2007-12-28 |
| 1821005539 | Yaw B Frimpong-badu | Internal Medicine | 17201 I H 45 S, Shenandoah, TX 77385 | 2006-08-02 |
| 1497754642 | Vicky L Taylor-mckenna | Nurse Practitioner | 17201 I H 45 S, Shenandoah, TX 77385-3311 | 2005-07-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134727423 | Victoria Templeton | Marriage & Family Therapist | 256 Ed English Dr., Building 4, Unit C, Shenandoah, TX 77385 | 2020-10-09 |
| 1760089296 | Mark Evar Espiritu Ogbac | Specialist/Technologist, Other | 2119 Pacific Loon Lane, Conroe, TX 77385 | 2020-10-07 |
| 1285255380 | Tiffany Tran | Pharmacist | 10200 Hwy 242, Conroe, TX 77385 | 2020-04-29 |
| 1447898994 | Harper's Preserve Dentistry, PC | Dentist | 10160 Hwy 242, Ste 100, Conroe, TX 77385 | 2019-12-16 |
| 1104462753 | Over The Moon Pediatrics, Pllc | Pediatrics | 17189 I-45 South, Suite 235, The Woodlands, TX 77385 | 2019-11-19 |
| 1053973453 | Mark William Riepl | Behavior Technician | 19445 David Memorial Dr, Unit #1707, Shenandoah, TX 77385 | 2019-07-05 |
| 1225690134 | H-e-b, Lp | Clinical Medical Laboratory | 10200 Highway 242, Conroe, TX 77385 | 2019-07-01 |
| 1932766235 | Houston Mint Dentistry, Pllc | Dentist | 19073 Interstate 45 N Suite 185, Shenandoah, TX 77385 | 2019-05-22 |
| 1255808283 | Ntn Dental Pllc | Clinic/Center | 10161 Highway 242, Suite 100, Conroe, TX 77385 | 2018-10-29 |
| 1164902094 | Lindsay Taylor Fleming | Specialist/Technologist | 19221, Interstate 45 S. Ste. 120, Shenandoah, TX 77385 | 2018-08-20 |
| Find all providers in zip 77385 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821600487 | Fristanto Kurniawan | Nurse Practitioner | 9250 Pinecroft Dr, Shenandoah, TX 77380-3218 | 2020-08-17 |
| 1811508963 | Spicelyn A Cross | Nurse Practitioner | 9250 Pinecroft Dr, Shenandoah, TX 77380-3218 | 2020-08-12 |
| 1780213983 | Onome Edokun | Nurse Practitioner | 123 Vision Park Blvd, Shenandoah, TX 77384-3001 | 2020-04-08 |
| 1447881552 | Kimberly Ann Quinn | Nurse Practitioner | 17201 I H 45 S, Shenandoah, TX 77385-3311 | 2020-01-28 |
| 1588202170 | Megan Blair Jennings | Nurse Practitioner | 9250 Pinecroft Dr, Shenandoah, TX 77380-3218 | 2019-12-15 |
| 1114560075 | Kimberlee Erin Spurlin | Nurse Practitioner | 9250 Pinecroft Dr, Shenandoah, TX 77380-3218 | 2019-10-23 |
| 1073154779 | Wilma Juliana Barboza | Nurse Practitioner | 9250 Pinecroft Dr, Shenandoah, TX 77380-3218 | 2019-10-03 |
| 1114583978 | Pauline Omwenga Mwebi | Nurse Practitioner | 9250 Pinecroft Dr, Shenandoah, TX 77380-3218 | 2019-05-16 |
| 1417418146 | Rhona Earley | Nurse Practitioner | 17201 I 45 S, Shenandoah, TX 77385-3311 | 2019-03-26 |
| 1861959132 | Sarah Aileene Cruz | Nurse Practitioner | 17201 Interstate 45 S, Shenandoah, TX 77385-3311 | 2019-02-22 |
| Find all providers in SHENANDOAH | ||||
| City | SHENANDOAH |
| Zip Code | 77385 |
Please comment or provide details below to improve the information on JACQUELYN RENNEBERG.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.