| Renew Health Llc | |
|
207 N Union Ave Ste E Roswell NM 88201-3068 | |
| (940) 399-6165 | |
| Not Available |
| Full Name | Renew Health Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 207 N Union Ave Ste E, Roswell, New Mexico |
| Authorized Official Name and Position | Robert Trent Carter (OWNER) |
| Authorized Official Contact | 5753633189 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renew Health Llc 207 N Union Ave Ste E Roswell NM 88201-3068 Ph: (575) 363-3189 | Renew Health Llc 207 N Union Ave Ste E Roswell NM 88201-3068 Ph: (940) 399-6165 |
| NPI Number | 1336808831 |
|---|---|
| Provider Enumeration Date | 12/12/2021 |
| Last Update Date | 03/16/2026 |
| Certification Date | 03/16/2026 |
| Medicare PECOS PAC ID | 7214314723 |
|---|---|
| Medicare Enrollment ID | O20220520002123 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336808831 | NPI | - | NPPES |
| Provider Name | Robert Trent Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346812245 PECOS PAC ID: 8123405636 Enrollment ID: I20220520002192 |
| Provider Name | Christie Haase |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972287183 PECOS PAC ID: 8022463280 Enrollment ID: I20231009002954 |
| Provider Name | Jennifer Amanda Barela |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831954841 PECOS PAC ID: 9133560766 Enrollment ID: I20240514003598 |
| Provider Name | Kafayat Olateju Popoola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073335436 PECOS PAC ID: 9931620879 Enrollment ID: I20250307000148 |
| Provider Name | Adrienne Lynn Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225748437 PECOS PAC ID: 3779956412 Enrollment ID: I20250312000848 |
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