Basic Information
| Provider Information | |||||||||
| NPI: | 1770083024 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REDMAN | ||||||||
| FirstName: | ADELINE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1700 E DESERT INN RD STE 314 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891693207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7028391088 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1701 N GREEN VALLEY PKWY STE 9A | ||||||||
| Address2: | |||||||||
| City: | HENDERSON | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89074 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7024071100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2018 | ||||||||
| LastUpdateDate: | 08/02/2018 | ||||||||
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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 | 3747A0650X | Y | Nursing Service Related Providers | Technician | Attendant Care Provider |
No ID Information.