Healthcare Provider Details

I. General information

NPI: 1518607803
Provider Name (Legal Business Name): OLIVIA JO RENNER GARVEY DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2022
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 SAINT FRANCIS DR
CAPE GIRARDEAU MO
63703-5049
US

IV. Provider business mailing address

PO BOX 801143
KANSAS CITY MO
64180-1143
US

V. Phone/Fax

Practice location:
  • Phone: 573-339-1166
  • Fax: 573-339-7166
Mailing address:
  • Phone: 573-331-5583
  • Fax: 573-331-5079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2026024252
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: