Healthcare Provider Details

I. General information

NPI: 1952030173
Provider Name (Legal Business Name): BILLIE PAMELA BAKER-REDMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2022
Last Update Date: 06/06/2022
Certification Date: 06/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 ENTERPRISE DR
WINCHESTER KY
40391-9668
US

IV. Provider business mailing address

1100 ENTERPRISE DR
WINCHESTER KY
40391-9668
US

V. Phone/Fax

Practice location:
  • Phone: 859-745-2200
  • Fax:
Mailing address:
  • Phone: 859-745-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0106X
TaxonomyOccupational Health Registered Nurse
License Number1060485
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: