Healthcare Provider Details

I. General information

NPI: 1841456951
Provider Name (Legal Business Name): TAMMY LYNN REDL HIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2008
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3509 E SHEA BLVD STE 117
PHOENIX AZ
85028-3339
US

IV. Provider business mailing address

2 N CENTRAL AVE FL 1819
PHOENIX AZ
85004-2322
US

V. Phone/Fax

Practice location:
  • Phone: 720-385-3700
  • Fax: 602-996-3060
Mailing address:
  • Phone: 602-562-9077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: