Provider Demographics
NPI:1114120680
Name:REDMAN, ALYSON LEIGH (FNP-BC, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:ALYSON
Middle Name:LEIGH
Last Name:REDMAN
Suffix:
Gender:F
Credentials:FNP-BC, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 HILL COUNTRY DR
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-6024
Mailing Address - Country:US
Mailing Address - Phone:830-258-7762
Mailing Address - Fax:830-258-7098
Practice Address - Street 1:222 SIDNEY BAKER ST S STE 500
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028
Practice Address - Country:US
Practice Address - Phone:830-895-7675
Practice Address - Fax:830-896-9340
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX681148363LF0000X
TXAP115941363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX312187303Medicaid
TX00628NOtherGROUP PTAN-MEDICARE