Provider Demographics
NPI:1710195045
Name:HUETTENMUELLER, RENEE MICHELLE
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:MICHELLE
Last Name:HUETTENMUELLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 CHARLOTTE ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66216-2131
Mailing Address - Country:US
Mailing Address - Phone:913-962-5531
Mailing Address - Fax:
Practice Address - Street 1:6400 CHARLOTTE ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66216-2131
Practice Address - Country:US
Practice Address - Phone:913-962-5531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider