Healthcare Provider Details

I. General information

NPI: 1275521684
Provider Name (Legal Business Name): NANCY REDECKER APRN, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 DEL PRADO BLVD S
CAPE CORAL FL
33990-5617
US

IV. Provider business mailing address

PO BOX 2147
FT MYERS FL
33902-2147
US

V. Phone/Fax

Practice location:
  • Phone: 239-424-2060
  • Fax: 239-424-2061
Mailing address:
  • Phone: 239-343-6100
  • Fax: 239-343-9925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberRN1340882
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: