Individual
STACY SHANTE REDMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
3103 SIERRA CT, COLUMBUS, MS 39705-1807
(662) 889-7528
Mailing address
3103 SIERRA CT, COLUMBUS, MS 39705-1807
(662) 889-7528
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
903311
MS
Other
Enumeration date
08/24/2022
Last updated
08/24/2022
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