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MRS. RENEE LYNN VANDEN AVOND
>> Home Health Aide >> Nursing Service Related ProvidersRegistrant NPI Number: 1568126464
Individual Registrant:MRS. RENEE LYNN VANDEN AVOND
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
525 ROBERT ST S PIERZ, MN 56364-7158 US
Tel: 218-838-8408 Fax: --
Tel: 218-838-8408 Fax: --
Contact information for business:
525 ROBERT ST S PIERZ, MN 56364-7158 US
Tel: 218-838-8408 Fax: --
Tel: 218-838-8408 Fax: --
Registration Information:
NPI: 1568126464
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 374U00000X | Nursing Service Related Providers Home Health Aide | MN | 256577 |
| Y | 374U00000X | Nursing Service Related Providers Home Health Aide | MN | 1110841 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| VENDOR NUMBER | 256577 | MN | 01 |
| AFC LICENSE | 1110841 | MN | 01 |
| BACKGROUND STUDY | 1111492 | MN | 01 |
