Provider Demographics
NPI:1720632516
Name:REDMOND, KURTIS WINSTON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KURTIS
Middle Name:WINSTON
Last Name:REDMOND
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3749 CARPENTER RD
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-9809
Mailing Address - Country:US
Mailing Address - Phone:734-975-4675
Mailing Address - Fax:
Practice Address - Street 1:3749 CARPENTER RD
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-9809
Practice Address - Country:US
Practice Address - Phone:734-975-4675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302411702183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist