MEDICARE: THERESA 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	363L00000X	Nurse Practitioner	268297	AZ

General Provider Information

NPI Number	:	1740149509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THERESA REDMOND

Provider Business Mailing Address
First Line	:	6460 E MCDOWELL RD APT 1126
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85257-0004
Country	:	US
Telephone Number	:	503-816-1532
Fax Number	:

Provider Business Practice Location Address
First Line	:	4455 E CAMELBACK RD STE A215
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-2897
Country	:	US
Telephone Number	:	503-816-1532
Fax Number	:

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

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/22/2026

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Directions to “ THERESA REDMOND ” Practice Location

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