Healthcare Provider Details

I. General information

NPI: 1114120680
Provider Name (Legal Business Name): ALYSON LEIGH REDMAN FNP-BC, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 SIDNEY BAKER ST S STE 500
KERRVILLE TX
78028
US

IV. Provider business mailing address

575 HILL COUNTRY DR
KERRVILLE TX
78028-6024
US

V. Phone/Fax

Practice location:
  • Phone: 830-895-7675
  • Fax: 830-896-9340
Mailing address:
  • Phone: 830-258-7762
  • Fax: 830-258-7098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number681148
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP115941
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP115941
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: