Provider Demographics
NPI:1780639898
Name:REDMOND, KATRINA P (WHNP)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:P
Last Name:REDMOND
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 38
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28603-0038
Mailing Address - Country:US
Mailing Address - Phone:828-322-4140
Mailing Address - Fax:828-322-3767
Practice Address - Street 1:1501 TATE BLVD SE
Practice Address - Street 2:SUITE 201
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-1385
Practice Address - Country:US
Practice Address - Phone:828-322-4140
Practice Address - Fax:828-322-3767
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC800078363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP14185Medicare UPIN
NC2599315Medicare ID - Type Unspecified