Provider Demographics
NPI:1386429926
Name:REDMAN, AYLA AUSTIN
Entity type:Individual
Prefix:MS
First Name:AYLA
Middle Name:AUSTIN
Last Name:REDMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AYLA
Other - Middle Name:
Other - Last Name:MULHERN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2937 SAN PEDRO DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-3328
Mailing Address - Country:US
Mailing Address - Phone:505-205-5430
Mailing Address - Fax:
Practice Address - Street 1:2937 SAN PEDRO DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-3328
Practice Address - Country:US
Practice Address - Phone:505-205-5430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-30
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM81323163WP0809X
NM79887363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult