Provider Demographics
NPI:1417554361
Name:REDMOND, JOHN PEARSON (PMHNP-BC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:PEARSON
Last Name:REDMOND
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 GERMANTOWN CT STE 207
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-4258
Mailing Address - Country:US
Mailing Address - Phone:901-878-3332
Mailing Address - Fax:901-350-7790
Practice Address - Street 1:65 GERMANTOWN CT STE 207
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-4258
Practice Address - Country:US
Practice Address - Phone:901-878-3332
Practice Address - Fax:901-350-7790
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-05
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN28418363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN28418OtherPSYCHIATRY