Heath Russell Renner in St Louis Park - Physician Assistant
Heath Russell Renner - NPI 1285645044
Heath Russell Renner is a Physician Assistant in St Louis Park, Minnesota. Heath Russell Renner practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Heath Russell Renner is 1285645044. The last update date is 2007-07-11.
Heath Russell Renner's current location address is 6465 Wayzata Blvd, St Louis Park, Minnesota. You can contact this provider via phone number 9525125600 and fax number 9525125650. The mailing address for Heath Russell Renner is 6465 Wayzata Blvd, St Louis Park, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Heath Russell Renner |
|---|---|
| Address | 6465 Wayzata Blvd, St Louis Park, Minnesota |
| Phone Number | 9525125600 |
| Fax Number | 9525125650 |
| Sole Proprietor | Y |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1285645044 |
|---|---|
| Provider Enumeration Date | 2006-08-10 |
| Last Updated Date | 2007-07-11 |
Provider Mailing Address Detail
| Address | 6465 Wayzata Blvd |
|---|---|
| City | St Louis Park |
| State | Minnesota (MN) |
| Post Code | 554261728 |
| Phone Number | 9525125600 |
| Fax Number | 9525125650 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 9757 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 969991033651 | PREFERREDONE | ||
| 065G8RE | BLUECROSS BLUESHIELD | ||
| 116980 | MEDICA | ||
| 13138C564 | UCARE | ||
| HP39821 | HEALTHPARTNERS |
Post Comment/ Review Below
What is the Heath Russell Renner's unique identification number?
The Heath Russell Renner has been assigned the NPI (National Provider Identifier) Number 1285645044 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Where is the Heath Russell Renner located?
The Heath Russell Renner is located at 6465 Wayzata Blvd, St Louis Park, MN 554261728.
What is Heath Russell Renner's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Heath Russell Renner is Physician Assistant, and the taxonomy classification code that categorizes this area of expertise is 363A00000X.
On what date did the Heath Russell Renner receive the assignment of its 1285645044 from the Centers for Medicare & Medicaid Services?
The Heath Russell Renner was issued its 1285645044 by the Centers for Medicare & Medicaid Services on 2006-08-10.
When was the information related to Heath Russell Renner most recently updated or refreshed?
The details pertaining to the Heath Russell Renner, including its address, specialty, and other relevant information, were last updated or refreshed on 2007-07-11.
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