Individual provider · Type 1 NPI

Holly Maye Renner

Student in an Organized Health Care Education/Training Program · Mishawaka, IN

NPI number 1912831579 Active

Practice location

215 W 4th St
Mishawaka, IN 46544-1917

Call (574) 302-7163 Map

Fax (574) 544-0066

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1912831579

Holly Maye Renner's National Provider Identifier is 1912831579, issued on Jun 10, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Mishawaka, IN. The record was last updated on Jun 10, 2026.