Provider Demographics
NPI:1205384971
Name:REDMOND, JOYCE MARIE (STNA)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:MARIE
Last Name:REDMOND
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5201 E 113TH ST
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-2736
Mailing Address - Country:US
Mailing Address - Phone:216-816-4963
Mailing Address - Fax:
Practice Address - Street 1:5201 E 113TH ST
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125-2736
Practice Address - Country:US
Practice Address - Phone:216-816-4963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401863370516376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide