Individual
DR. VANESSA LYNN WIDNER REN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5100 NW WAUKOMIS DR STE A, NORTHMOOR, MO 64151-3516
(913) 980-4697
(844) 380-1190
Mailing address
5100 NW WAUKOMIS DR STE A, NORTHMOOR, MO 64151-3516
(913) 980-4697
(844) 380-1190
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2013037136
MO
207QA0401X
Addiction Medicine (Family Medicine) Physician
2013037136
MO
207QA0505X
Adult Medicine Physician
2013037136
MO
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
2013037136
MO
Other
Enumeration date
07/20/2010
Last updated
02/20/2018
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