Provider Demographics
NPI:1699544189
Name:RENUE PSYCHIATRY PLLC
Entity type:Organization
Organization Name:RENUE PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF ENTITY
Authorized Official - Prefix:
Authorized Official - First Name:NNEKA
Authorized Official - Middle Name:MARIAGORETTI
Authorized Official - Last Name:ONYIA
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:480-544-4400
Mailing Address - Street 1:1215 N IVY LOOP STE 101
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-5406
Mailing Address - Country:US
Mailing Address - Phone:480-544-4400
Mailing Address - Fax:480-534-6706
Practice Address - Street 1:1215 N IVY LOOP STE 101
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-5406
Practice Address - Country:US
Practice Address - Phone:480-544-4400
Practice Address - Fax:480-534-6706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-26
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty