| Renae Jenelle Richardson, | |
|
11863 State Highway 13, Kimberling City, MO 65686-8362 | |
| (417) 739-1995 | |
| Not Available |
| Full Name | Renae Jenelle Richardson |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 5 Years |
| Location | 11863 State Highway 13, Kimberling City, Missouri |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659045847 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 2021019189 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mercy Hospital Springfield | Springfield, MO | Hospital |
| Mercy Hospital Lebanon | Lebanon, MO | Hospital |
| Mercy Hospital Cassville | Cassville, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mercy Clinic Springfield Communities | 7416865845 | 1121 |
| Entity Name | Mercy Clinic Springfield Communities |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245277631 PECOS PAC ID: 7416865845 Enrollment ID: O20031104000060 |
| Entity Name | Mercy Clinic Springfield Communities |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972771657 PECOS PAC ID: 7416865845 Enrollment ID: O20031218000354 |
| Mailing Address | Practice Location Address |
|---|---|
| Renae Jenelle Richardson, 4332 E Ambrose Dr, Springfield, MO 65802-2425 Ph: (417) 251-2922 | Renae Jenelle Richardson, 11863 State Highway 13, Kimberling City, MO 65686-8362 Ph: (417) 739-1995 |
Renita W. Randall, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 11863 State Highway 13, Kimberling City, MO 65686 Phone: 417-739-1995 Fax: 417-739-1893 |