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General NPI Number Information
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NPI Number | 1437357472
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Entity Type | Individual
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Provider Name | JASON D REDWINE FNP-C
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Gender | Male
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Dates
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Enumeration Date | 07/10/2007
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 930 ROY RICHARD DR
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City | SCHERTZ
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State | TX
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Zip | 78154-1050
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Country | US
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Telephone | 872-231-3162
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 74008272
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City | CHICAGO
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State | IL
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Zip | 60674-8272
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Country | US
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Telephone | 702-899-0595
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Fax | 702-977-1496
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP136499
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | CNP-02934
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 7718
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License Number State | AZ
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