MEDICARE: TAMMY LYNN REDL HIS

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	237700000X	Hearing Instrument Specialist

General Provider Information

NPI Number	:	1841456951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMMY LYNN REDL HIS

Provider Business Mailing Address
First Line	:	2 N CENTRAL AVE FL 1819
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85004-2322
Country	:	US
Telephone Number	:	602-562-9077
Fax Number	:

Provider Business Practice Location Address
First Line	:	3509 E SHEA BLVD STE 117
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85028-3339
Country	:	US
Telephone Number	:	720-385-3700
Fax Number	:	602-996-3060

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

Provider Enumeration Date	:	07/29/2008
Last Update Date	:	03/20/2025

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