Individual
JANA LEIGH REDWINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
301 UTICA AVE, LUBBOCK, TX 79416-3111
(806) 797-4985
(806) 744-7545
Mailing address
301 UTICA AVE, LUBBOCK, TX 79416-3111
(806) 797-4985
(806) 744-7545
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA04272
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8N7639
BLUE CROSS/BLUE SHIELD TX
TX
01
—
P00277809
MEDICARE RAILROAD
TX
Enumeration date
05/23/2006
Last updated
02/04/2022
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