Provider Demographics
NPI:1467118406
Name:REDMON, KATIE RAE (APRN,MSN,FNP-C)
Entity Type:Individual
Prefix:MISS
First Name:KATIE
Middle Name:RAE
Last Name:REDMON
Suffix:
Gender:F
Credentials:APRN,MSN,FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34866 US HIGHWAY 19 N # 27
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-1918
Mailing Address - Country:US
Mailing Address - Phone:727-683-0038
Mailing Address - Fax:
Practice Address - Street 1:18596 FERNVIEW ST
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34638-6232
Practice Address - Country:US
Practice Address - Phone:727-846-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-15
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL746227163W00000X
FL11017575363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse