Provider Demographics
NPI:1467852509
Name:REDMAN, NATALIE REBECCA (LPN CERTIFICATE)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:REBECCA
Last Name:REDMAN
Suffix:
Gender:F
Credentials:LPN CERTIFICATE
Other - Prefix:MISS
Other - First Name:NATALIE
Other - Middle Name:REBECCA
Other - Last Name:SCHMELEBECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN CERTIFICATE
Mailing Address - Street 1:2986 GRASSLAND DR
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-5916
Mailing Address - Country:US
Mailing Address - Phone:406-926-3447
Mailing Address - Fax:406-926-1501
Practice Address - Street 1:2986 GRASSLAND DR
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-5916
Practice Address - Country:US
Practice Address - Phone:406-926-3447
Practice Address - Fax:406-926-1501
Is Sole Proprietor?:No
Enumeration Date:2014-08-26
Last Update Date:2015-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT33001164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0391709Medicaid