Provider Demographics
NPI:1659260420
Name:REDMON, KATELIN (APRN)
Entity type:Individual
Prefix:
First Name:KATELIN
Middle Name:
Last Name:REDMON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 WASECA LN
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-3059
Mailing Address - Country:US
Mailing Address - Phone:352-408-6019
Mailing Address - Fax:
Practice Address - Street 1:33049 PROFESSIONAL DR STE 103
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34788-3705
Practice Address - Country:US
Practice Address - Phone:352-353-6967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-28
Last Update Date:2025-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11040487363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner