Provider Demographics
NPI:1932482775
Name:REDICK, GUINEVERE JANE (MD)
Entity Type:Individual
Prefix:DR
First Name:GUINEVERE
Middle Name:JANE
Last Name:REDICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2114 AIRPORT BLVD STE 1000
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8926
Mailing Address - Country:US
Mailing Address - Phone:850-476-3696
Mailing Address - Fax:850-477-3573
Practice Address - Street 1:2114 AIRPORT BLVD STE 1000
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8926
Practice Address - Country:US
Practice Address - Phone:850-476-3696
Practice Address - Fax:850-477-3573
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME134330207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology