Provider Demographics
NPI:1306805809
Name:REDMON, VALERIE W (CRNA)
Entity type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:W
Last Name:REDMON
Suffix:
Gender:F
Credentials:CRNA
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Other - Last Name:
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Mailing Address - Street 1:PO BOX 44008
Mailing Address - Street 2:UFJP PROVIDER ENROLLMENT
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32231-4008
Mailing Address - Country:US
Mailing Address - Phone:904-244-3199
Mailing Address - Fax:904-244-3425
Practice Address - Street 1:655 W 8TH ST
Practice Address - Street 2:UFJP ANESTHESIA DEPT
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-6511
Practice Address - Country:US
Practice Address - Phone:904-244-4195
Practice Address - Fax:904-244-4908
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP3367372367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000924767AMedicaid
GA000924767CMedicaid
FL3002667-00Medicaid
GA000924767CMedicaid
GA000924767AMedicaid