Healthcare Provider Details

I. General information

NPI: 1326988213
Provider Name (Legal Business Name): JUAN N REDMOND
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1426 HILLARY DR
SLIDELL LA
70461-4515
US

IV. Provider business mailing address

1426 HILLARY DR
SLIDELL LA
70461-4515
US

V. Phone/Fax

Practice location:
  • Phone: 504-256-5260
  • Fax:
Mailing address:
  • Phone: 504-256-5260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number296958
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: