Individual
MRS. RENEE ANN ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
915 W MAPLE ST, COLUMBUS, KS 66725-1508
(471) 310-9286
Mailing address
2699 NE LAWTON RD, COLUMBUS, KS 66725-2078
(620) 762-1081
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
14-150198-022
KS
363LF0000X
Family Nurse Practitioner
Primary
53-82256-022
KS
Other
Enumeration date
06/11/2022
Last updated
09/18/2023
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