Provider Demographics
NPI:1295205748
Name:REDMAN, NINA ELIZABETH (RD)
Entity Type:Individual
Prefix:MS
First Name:NINA
Middle Name:ELIZABETH
Last Name:REDMAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:FORESTVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95436-9477
Mailing Address - Country:US
Mailing Address - Phone:707-887-1647
Mailing Address - Fax:707-887-1440
Practice Address - Street 1:6550 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:FORESTVILLE
Practice Address - State:CA
Practice Address - Zip Code:95436-9477
Practice Address - Country:US
Practice Address - Phone:707-887-1647
Practice Address - Fax:707-887-1440
Is Sole Proprietor?:No
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
981284133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered