Healthcare Provider Details

I. General information

NPI: 1558936526
Provider Name (Legal Business Name): RANESHIA ROBINSON NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2021
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 W US HIGHWAY 24
INDEPENDENCE MO
64050-2337
US

IV. Provider business mailing address

1010 W US HIGHWAY 24
INDEPENDENCE MO
64050-2337
US

V. Phone/Fax

Practice location:
  • Phone: 816-608-3411
  • Fax: 816-608-2921
Mailing address:
  • Phone: 816-608-3411
  • Fax: 816-608-2921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2021018490
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: