Provider Demographics
NPI:1568052801
Name:DIANE RENNIRT MD, PLLC
Entity type:Organization
Organization Name:DIANE RENNIRT MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:RENNIRT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-713-0777
Mailing Address - Street 1:400 BLANKENBAKER PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40243-1850
Mailing Address - Country:US
Mailing Address - Phone:502-713-0777
Mailing Address - Fax:502-713-0778
Practice Address - Street 1:400 BLANKENBAKER PKWY STE 201
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-1850
Practice Address - Country:US
Practice Address - Phone:502-713-0777
Practice Address - Fax:502-713-0778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-20
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty