Provider Demographics
NPI:1689859019
Name:RENFRO, GRETCHEN WENDELIN (RN, NP-C, FNP)
Entity type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:WENDELIN
Last Name:RENFRO
Suffix:
Gender:F
Credentials:RN, NP-C, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9501 N OAK TRFY STE 201
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-2201
Mailing Address - Country:US
Mailing Address - Phone:816-420-8282
Mailing Address - Fax:
Practice Address - Street 1:9501 N OAK TRFY STE 201
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64155-2201
Practice Address - Country:US
Practice Address - Phone:816-420-8282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-03
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMO110776363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily