Provider Demographics
NPI:1568679066
Name:RENKOSKI, KYMBERLY DENISE (WHNP)
Entity Type:Individual
Prefix:MS
First Name:KYMBERLY
Middle Name:DENISE
Last Name:RENKOSKI
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:219 BRYN WYCK PL
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8008
Mailing Address - Country:US
Mailing Address - Phone:314-606-0247
Mailing Address - Fax:
Practice Address - Street 1:16216 BAXTER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-4770
Practice Address - Country:US
Practice Address - Phone:636-449-4700
Practice Address - Fax:636-449-2595
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO092580363LW0102X
MO363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO092580OtherRN