MEDICARE: RENA REDWINE

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	251E00000X	Home Health Agency		CO

General Provider Information

NPI Number	:	1477421063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENA REDWINE

Provider Business Mailing Address
First Line	:	5561 E MARTIN LUTHER KING JR BLVD
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80207-2023
Country	:	US
Telephone Number	:	720-590-0805
Fax Number	:

Provider Business Practice Location Address
First Line	:	5561 E MARTIN LUTHER KING JR BLVD
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80207-2023
Country	:	US
Telephone Number	:	720-590-0805
Fax Number	:

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

Provider Enumeration Date	:	10/27/2025
Last Update Date	:	10/27/2025

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Directions to “ RENA REDWINE ” Practice Location

Language	Start Address	Practice Location

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