Doctor Name: | MS. KIMBERLY LAJUAN REDMOND |
NPI Number: | 1033408745 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSN, CPNP, NP-C |
License Number: | ARNP 9194115 |
Business Practice Address: | 963 Town Center Dr Suite 100 Orange City, FL - 327638254 |
Business Phone Number: | 3867749880 |
Business Fax Number: | 3867742898 |
Mailing Address: | Po Box 953577, LAKE MARY |
State: | FL |
Postal Code: | 327953577 |
Phone Number: | 3867749880 |
Fax Number: | 3867742898 |
NPI Enumeration Date: | 04/04/2011 |
NPI Last Update Date: | 07/30/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | ARNP 9194115 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |