Individual
RENEE D IDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
4921 PARKVIEW PL, SAINT LOUIS, MO 63110-1032
(314) 454-8134
(314) 454-8180
Mailing address
4921 PARKVIEW PL, SAINT LOUIS, MO 63110-1032
(314) 454-8134
(314) 454-8180
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
117226
MO
363LA2200X
Adult Health Nurse Practitioner
517511
CA
Other
Enumeration date
07/22/2006
Last updated
04/05/2022
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