Basic Information
| Provider Information | |||||||||
| NPI: | 1831255124 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REDMAN | ||||||||
| FirstName: | HOLLY | ||||||||
| MiddleName: | ELLEN | ||||||||
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| Credential: | RN, RNFA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2032 LORETO PLACE | ||||||||
| Address2: | |||||||||
| City: | PLACENTIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92870 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7145728765 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2922 ALDERGROVE CT | ||||||||
| Address2: | |||||||||
| City: | FULLERTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928354327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7142551076 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/29/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 163WR0006X | 343493 | CA | Y | Nursing Service Providers | Registered Nurse | Registered Nurse First Assistant |
No ID Information.