Basic Information
| Provider Information | |||||||||
| NPI: | 1700862208 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RENNINGER | ||||||||
| FirstName: | CAROL | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15 W. ROMNEY PLACE | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | CAPE MAY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6104421717 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 MUNRO DR | ||||||||
| Address2: | SAMUEL CALL HEALTH SERVICES CENTER | ||||||||
| City: | CAPE MAY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 082045000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6098986610 | ||||||||
| FaxNumber: | 6098986962 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/16/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | MP000749 | NJ | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | 363AM0700X | C01976 | MD | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | 363AM0700X | MA002636L | PA | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | 363AM0700X | C50000214 | DE | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.