Healthcare Provider Details

I. General information

NPI: 1659184018
Provider Name (Legal Business Name): EVA RENSING FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19550 E 39TH ST S STE 335
INDEPENDENCE MO
64057-2311
US

IV. Provider business mailing address

2800 CLAY EDWARDS DRIVE, CENTRAL VERIFICATION OFFICE AND PAYOR ENROLLMENT
NORTH KANSAS CITY MO
64116
US

V. Phone/Fax

Practice location:
  • Phone: 816-350-0005
  • Fax:
Mailing address:
  • Phone: 816-691-1655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2025001696
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2025001696
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: