Individual
MRS. MARY REDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
062410
MO
363LP0200X
Pediatric Nurse Practitioner
Primary
062410
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420038232
—
MO
Enumeration date
07/18/2011
Last updated
06/13/2019
Update your record
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