| NPI | 1659993152 | 
|---|---|
| Former Name | RENEE NELLIS/DEJAYNES | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 367A00000X Advanced Practice Midwife (Licence: KY 3011101)  | 
| Additional Taxonomies | 367A00000X Advanced Practice Midwife (Licence: IN 09000287A)  | 
| 367A00000X Advanced Practice Midwife (Licence: CNM04005)  | |
| Enumeration Date | 2020-05-07 | 
| Last Update Date | 2023-12-01 |