Provider Demographics
NPI:1023996279
Name:REDMOND, DEANDRE
Entity type:Individual
Prefix:
First Name:DEANDRE
Middle Name:
Last Name:REDMOND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:DEANDRE
Other - Middle Name:
Other - Last Name:REDMOND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:620 MEADOWGRASS DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-3813
Mailing Address - Country:US
Mailing Address - Phone:314-677-7190
Mailing Address - Fax:
Practice Address - Street 1:620 MEADOWGRASS DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-3813
Practice Address - Country:US
Practice Address - Phone:314-677-7190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide