Healthcare Provider Details

I. General information

NPI: 1285334292
Provider Name (Legal Business Name): SCOTT ANTHONY REDMOND CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2023
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10628 PARK RD
CHARLOTTE NC
28210-8407
US

IV. Provider business mailing address

3511 E LITTLE HILL RD
SIERRA VISTA AZ
85635-5601
US

V. Phone/Fax

Practice location:
  • Phone: 704-667-1000
  • Fax:
Mailing address:
  • Phone: 520-236-2498
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number7301
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number228043
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: