Provider Demographics
NPI:1568478568
Name:REDMOND, REBECCA ANN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:ANN
Last Name:REDMOND
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:494 W INTERSTATE 30
Mailing Address - Street 2:
Mailing Address - City:ROYSE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75189-7527
Mailing Address - Country:US
Mailing Address - Phone:972-635-2186
Mailing Address - Fax:972-635-2198
Practice Address - Street 1:494 W INTERSTATE 30
Practice Address - Street 2:
Practice Address - City:ROYSE CITY
Practice Address - State:TX
Practice Address - Zip Code:75189-7527
Practice Address - Country:US
Practice Address - Phone:972-635-2186
Practice Address - Fax:972-635-2198
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX638379363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00773116OtherRAILROAD MEDICARE PROVIDER NUMBER
TX638379OtherSTATE LICENSE