Provider Demographics
NPI:1851449169
Name:REDMOND-ARCHER, HEATHER ALLYN (RN)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:ALLYN
Last Name:REDMOND-ARCHER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:HEATHER
Other - Middle Name:ALLYN
Other - Last Name:REDMOND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1925 E DAKOTA AVE STE G
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-4821
Mailing Address - Country:US
Mailing Address - Phone:559-600-4645
Mailing Address - Fax:
Practice Address - Street 1:1925 E DAKOTA AVE STE G
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-4821
Practice Address - Country:US
Practice Address - Phone:559-600-4645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA564564163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse