Individual
KIMBERLY L. REDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1605 MARTIN SPRINGS DR, ROLLA, MO 65401-2931
(417) 533-6010
(417) 533-6173
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2001004539
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
2010034566
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366510448
—
MO
01
—
431560263
TRICARE
—
01
—
970019029
RAILROAD MEDICARE
—
Enumeration date
11/30/2006
Last updated
10/24/2011
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