Individual
SHIRLEY REDFERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704263129
MI
363L00000X
Nurse Practitioner
Primary
NP-08156
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
126519048
HPMI
—
05
—
2571935
—
OH
01
—
281776607-006
MMOH
OH
01
—
4724303
MICHIGAN MEDICAID
MI
01
—
P00762660
RRMC
OH
Enumeration date
12/22/2005
Last updated
11/03/2023
Update your record
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