MEDICARE: AMBER-MARIE ALEXANDRIA REDMOND

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
1	363LF0000X	Family Nurse Practitioner	APRN.CNP.0030613	OH

General Provider Information

NPI Number	:	1467199174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER-MARIE ALEXANDRIA REDMOND

Provider Business Mailing Address
First Line	:	7124 BROOKSIDE DR
Second Line	:
City	:	LAMBERTVILLE
State	:	MI
Zip	:	48144-9518
Country	:	US
Telephone Number	:	419-467-4950
Fax Number	:

Provider Business Practice Location Address
First Line	:	5206 MONROE ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43623-4607
Country	:	US
Telephone Number	:	567-206-0020
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/14/2022
Last Update Date	:	05/14/2022

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Directions to “ AMBER-MARIE ALEXANDRIA REDMOND ” Practice Location

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