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NPI Code Detail

MEDICARE: VICKI LEE REDPATH

MEDICARE:   VICKI LEE REDPATH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAP133701TX
2363L00000XNurse Practitioner1081901ID

General Provider Information

NPI Number : 1326570961
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICKI LEE REDPATH
Provider Business Mailing Address
First Line : PO BOX 12187
Second Line :
City : AUGUSTA
State : GA
Zip : 30914-2187
Country : US
Telephone Number : 706-863-9595
Fax Number : 706-868-8375
Provider Business Practice Location Address
First Line : 3901 W 15TH ST
Second Line :
City : PLANO
State : TX
Zip : 75075-7738
Country : US
Telephone Number : 706-863-9595
Fax Number : 706-868-8375
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2017
Last Update Date : 06/23/2026

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Directions to “ VICKI LEE REDPATH ” Practice Location

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