Basic Information
| Provider Information | |||||||||
| NPI: | 1689237059 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REDMOND | ||||||||
| FirstName: | KELSEY | ||||||||
| MiddleName: | ELLEN | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1980 HIGHWAY 1 NE | ||||||||
| Address2: | |||||||||
| City: | SOLON | ||||||||
| State: | IA | ||||||||
| PostalCode: | 523339767 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3095029079 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1428 2ND AVE N | ||||||||
| Address2: | |||||||||
| City: | FORT DODGE | ||||||||
| State: | IA | ||||||||
| PostalCode: | 505014119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5155746110 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2019 | ||||||||
| LastUpdateDate: | 04/20/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | A154037 | IA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.