MEDICARE: GRETCHEN WENDELIN RENFRO RN, NP-C, FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	MO110776	MO

General Provider Information

NPI Number	:	1689859019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRETCHEN WENDELIN RENFRO RN, NP-C, FNP

Provider Business Mailing Address
First Line	:	9501 N OAK TRFY STE 201
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64155-2201
Country	:	US
Telephone Number	:	816-420-8282
Fax Number	:

Provider Business Practice Location Address
First Line	:	9501 N OAK TRFY STE 201
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64155-2201
Country	:	US
Telephone Number	:	816-420-8282
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2008
Last Update Date	:	01/03/2008

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