Most Relevant Information
Provider Data
| NPI Number: | 1003479080 |
| Provider Name: | JAIME MARIE RENNECKER |
| Entity Type: | Individual |
| Taxonomy Code: | 363LN0000X |
| Specialty: | Nurse Practitioner |
| License Number: | APRN.CNP.019380 |
Most Important Dates
| Enumeration Date: | 04/16/2019 |
| Last Updated: | 07/08/2019 |
Provider Practice Location
2600 SIXTH ST SW
CANTON
OH
447101702
Practice Location Phone/Fax
| Phone: | 3303635433 |
| Fax: | 3303637785 |
Provider Mailing Location
2600 6TH ST SW
CANTON
OH
447101702
Provider Mailing Phone/Fax
| Phone: | 3303635433 |
| Fax: | 3305806785 |