Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Rene L. Revelle, CNP

Individual provider Family Nurse Practitioner · NPI 1639584139

Rene L. Revelle, CNP is a Nurse Practitioner in Eldon, Missouri. Qualified in 2014, 12 years ago. Practices with Lake Regional Health System, a 131-clinician group and accepts Medicare assignment. Licensed in Missouri and Ohio.

Years since qualifying
12
Licensed in
MO, OH
In the registry since
2014
Specialties on file
2
What do these letters mean?
CNP — Certified Nurse Practitioner
A certified nurse practitioner.

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Practice location Address checks out

304A E 4th St
Eldon, MO 65026-1808
Phone: (573) 557-2400
Fax: (573) 557-2401
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 2015010647 (MO)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence COA15919NP (OH)

Record details

NPI number1639584139
Entity typeIndividual (Type 1)
GenderFemale
Credentials CNP
Sole proprietorNo
NPI enumeratedJune 24, 2014
Last updated in NPPESJune 29, 2015

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Lake Regional Health System — 131 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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