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Theresia Renner, PA-C
Surgical Physician Assistant in Madisonville, Kentucky
NPI 1740387372

Theresia Renner is a Surgical Physician Assistant based in Madisonville, KY and is specialized in Surgical. Theresia Renner practices in Madisonville, KY and has the professional credentials of PA-C. The NPI Number for Theresia Renner is 1740387372 and holds a License No. PA195 (Kentucky).

The current practice location address for Theresia Renner is 200 Clinic Dr, Madisonville, KY and can be reached out via phone at 270-825-7200.

Location: 200 Clinic Dr, Madisonville, KY, 42431-1661
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Provider Profile Details
NPI Number
1740387372
Provider Name
Theresia Renner
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
200 Clinic Dr, Madisonville, KY, 42431-1661
Phone Number
270-825-7200
Fax Number
Provider Enumeration Date
09/17/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000000107779 01 BCBS PROVIDER NUMBER
PA195 01 KY LICENSE
institution
Provider Business Practice Location Address Details
Address
200 Clinic Dr
City
State
Zip
42431-1661
Phone Number
270-825-7200
Fax Number
person
Provider Business Mailing Address Details
Address
200 Clinic Dr
City
State
Zip
42431-1661
Phone Number
270-825-7200
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
PA195 (Kentucky)
Definition
Definition to come...
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