Provider Demographics
NPI:1073884862
Name:SCHNELKER, RENEE R (ACNS)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:R
Last Name:SCHNELKER
Suffix:
Gender:F
Credentials:ACNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2912 ELLENDALE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63143-3414
Mailing Address - Country:US
Mailing Address - Phone:314-647-0021
Mailing Address - Fax:314-875-0382
Practice Address - Street 1:1423 S BIG BEND BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-2203
Practice Address - Country:US
Practice Address - Phone:314-875-0380
Practice Address - Fax:314-875-0382
Is Sole Proprietor?:No
Enumeration Date:2012-01-25
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO128961364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health