Individual
JAIME RENEE RENFRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3527 W TRUMAN BLVD, JEFFERSON CITY, MO 65109-5901
(573) 893-7848
(573) 893-1984
Mailing address
PO BOX 505673, SAINT LOUIS, MO 63150-5673
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2022024062
MO
363LA2200X
Adult Health Nurse Practitioner
Primary
2022024062
MO
363LF0000X
Family Nurse Practitioner
2022024062
MO
Other
Enumeration date
06/25/2022
Last updated
09/10/2024
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