Individual
RENITA W. RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3203 E OLD STONE RD, BROOKLINE, MO 65619-9620
(417) 269-1910
(417) 269-1916
Mailing address
PO BOX 802843, KANSAS CITY, MO 64180-2843
(417) 730-6430
(417) 269-7567
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
110109
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
427183702
—
MO
Enumeration date
10/14/2006
Last updated
01/13/2026
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