Healthcare Provider Details

I. General information

NPI: 1811354483
Provider Name (Legal Business Name): RENEA LYNN KESTEL MSN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2016
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 N 12TH ST
GUTHRIE CENTER IA
50115-1549
US

IV. Provider business mailing address

710 N 12TH ST
GUTHRIE CENTER IA
50115-1549
US

V. Phone/Fax

Practice location:
  • Phone: 641-332-2201
  • Fax: 641-332-3856
Mailing address:
  • Phone: 641-332-2201
  • Fax: 641-332-3856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA099552
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number4751
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: