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General NPI Number Information
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NPI Number | 1558836437
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Entity Type | Individual
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Provider Name | RENI JOSEPH FNP
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Gender | Female
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Dates
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Enumeration Date | 10/08/2018
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 12 HUTCHINSON RD
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City | BALLWIN
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State | MO
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Zip | 63011-5702
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Country | US
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Telephone | 636-591-1086
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Fax |
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Provider Business Mailing Address
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Address Line | 15138 STILL HOUSE CREEK RD
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City | CHESTERFIELD
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State | MO
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Zip | 63017-2434
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Country | US
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Telephone | 636-778-2393
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2018020357
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License Number State | MO
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