Healthcare Provider Details

I. General information

NPI: 1457960296
Provider Name (Legal Business Name): RENEE LOENEN MS, RN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2020
Last Update Date: 07/28/2020
Certification Date: 07/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 BLUE PKWY
KANSAS CITY MO
64130-2807
US

IV. Provider business mailing address

5329 NE SUNSHINE DR
LEES SUMMIT MO
64064-2449
US

V. Phone/Fax

Practice location:
  • Phone: 816-599-5764
  • Fax:
Mailing address:
  • Phone: 816-419-3937
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number099811
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: