Provider Demographics
NPI:1033308218
Name:REDMOND, KNIKIKIA L (CFTS)
Entity Type:Individual
Prefix:
First Name:KNIKIKIA
Middle Name:L
Last Name:REDMOND
Suffix:
Gender:F
Credentials:CFTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S WILMINGTON ST
Mailing Address - Street 2:SUITE 113
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27601-2364
Mailing Address - Country:US
Mailing Address - Phone:919-539-1058
Mailing Address - Fax:919-741-4351
Practice Address - Street 1:900 S WILMINGTON ST
Practice Address - Street 2:SUITE 113
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27601-2364
Practice Address - Country:US
Practice Address - Phone:919-539-1058
Practice Address - Fax:919-741-4351
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-23
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7795367Medicaid