Provider Demographics
NPI:1821657404
Name:REDMOND, MARY JEAN (ACAGNP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:JEAN
Last Name:REDMOND
Suffix:
Gender:F
Credentials:ACAGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BERWYN DR
Mailing Address - Street 2:
Mailing Address - City:OCEAN VIEW
Mailing Address - State:NJ
Mailing Address - Zip Code:08230-1462
Mailing Address - Country:US
Mailing Address - Phone:609-226-4271
Mailing Address - Fax:
Practice Address - Street 1:2500 ENGLISH CREEK AVE
Practice Address - Street 2:BLDG 400, 2D FL
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-5598
Practice Address - Country:US
Practice Address - Phone:609-677-7777
Practice Address - Fax:609-607-7277
Is Sole Proprietor?:No
Enumeration Date:2019-06-07
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00925500363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner