Renee Antonette Fletcher, CRNP FNP-BC
Individual provider Active NPI Family Nurse Practitioner · Edgewood, MD
NPI 1992049209 · NPPES record last updated Jun 29, 2022
Key facts
- NPI
- 1992049209
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R199709 (MD)
- Practice address
- 1401 Pulaski Hwy Ste W
Edgewood, MD 21040-1398 - Phone
- (410) 671-6900
- Fax
- (410) 671-6901
- NPI assigned
- Nov 27, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1401 Pulaski Hwy
Suite W
Edgewood, MD 21040-1398
Phone (410) 671-6900
1401 W Pulaski Hwy
Edgewood, MD 21040-1398
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171012001224 | MD | Practitioner - Nurse Practitioner | 6507135571 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Infinite Medical Express LLC | Current |
Accepting new patients |
Locations
1401 Pulaski Hwy
Ste W
Edgewood, MD 21040
Phone (410) 671-6900
1010 Edgewood Rd
Ste 104
Edgewood, MD 21040
Phone (410) 671-6900
1401 Pulaski Hwy
Edgewood, MD 21040
Phone (410) 671-6900
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/CABFCD/Endpoint/CABFCD
- https://api.platform.athenahealth.com/19446/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R199709 | MD | Yes |
Addresses
Primary practice location
1401 Pulaski Hwy Ste W
Edgewood, MD 21040-1398
Mailing address
1401 Pulaski Hwy Ste W
Edgewood, MD 21040-1398
Phone (104) 671-6900
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1840347P0001 | Medicaid | MD |
Other names
- Mrs. Renee Antonette Fletcher
Other providers in Edgewood, MD
- Comfort Eze
- Ezi-B Affordable Medical Transportation LLC
- Favor Healthcare Solutions, LLC
- Favorite Health Care LLC
- Reginald Michael Fenwick
- George E Fonjungo
- Angelique Franklin
- Allison Gardner
- Anupama Garlapati
- Gateway Healthcare Connections
All providers in Edgewood, MD · Family Nurse Practitioner in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 29, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.