Provider Demographics
NPI:1982897922
Name:REDMOND, NICOLE (MD, PHD, MPH)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:
Last Name:REDMOND
Suffix:
Gender:F
Credentials:MD, PHD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 11TH AVE S
Mailing Address - Street 2:MEDICAL TOWERS 610
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35294-4410
Mailing Address - Country:US
Mailing Address - Phone:205-934-0778
Mailing Address - Fax:205-934-7959
Practice Address - Street 1:1515 6TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1601
Practice Address - Country:US
Practice Address - Phone:205-279-2860
Practice Address - Fax:205-252-0197
Is Sole Proprietor?:No
Enumeration Date:2007-08-23
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA059498207R00000X
AL31189207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine