Provider Demographics
NPI:1720705908
Name:REDMAN, HEATHER (PROVIDER)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:REDMAN
Suffix:
Gender:F
Credentials:PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:749 S HAGUE AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204-2301
Mailing Address - Country:US
Mailing Address - Phone:614-632-2575
Mailing Address - Fax:
Practice Address - Street 1:749 S HAGUE AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-2301
Practice Address - Country:US
Practice Address - Phone:614-632-2575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility