Provider Demographics
NPI:1558802108
Name:REDMAN, KERI (CNM)
Entity Type:Individual
Prefix:MRS
First Name:KERI
Middle Name:
Last Name:REDMAN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:KERI
Other - Middle Name:
Other - Last Name:GEARHEART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2814 CRYSTAL SPRING AVE SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24014-3214
Mailing Address - Country:US
Mailing Address - Phone:540-239-6478
Mailing Address - Fax:
Practice Address - Street 1:2007 GRAVES MILL RD
Practice Address - Street 2:
Practice Address - City:FOREST
Practice Address - State:VA
Practice Address - Zip Code:24551-2656
Practice Address - Country:US
Practice Address - Phone:434-385-8948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-15
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024177976367A00000X
COAPN.0992892-CNM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife