Individual
TERESA B. REDMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1314 19TH AVE, MERIDIAN, MS 39301-4116
(601) 703-4415
(601) 703-4418
Mailing address
PO BOX 5183, MERIDIAN, MS 39302-5183
(601) 703-9506
(601) 703-3264
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R504955
MS
363LX0106X
Occupational Health Nurse Practitioner
R504955
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00118205
—
MS
01
—
500003752
RAILROAD MEDICARE
—
01
—
730-00516
BLUE CROSS OF AL
—
05
—
891001670
—
AL
Enumeration date
07/12/2005
Last updated
02/25/2010
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