Healthcare Provider Details

I. General information

NPI: 1174404446
Provider Name (Legal Business Name): WENDI REDFERN RN, ACNS-BC, APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2025
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 1997 MS 6804
MILWAUKEE WI
53201-1997
US

IV. Provider business mailing address

W213N16530 GLEN BROOKE DR
JACKSON WI
53037-9367
US

V. Phone/Fax

Practice location:
  • Phone: 414-266-2118
  • Fax:
Mailing address:
  • Phone: 262-707-2616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0200X
TaxonomyPediatric Clinical Nurse Specialist
License Number110852
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: