Provider Demographics
NPI:1538455266
Name:REDMOND, MICHELE MARIE (RN, BSN, CDE)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:MARIE
Last Name:REDMOND
Suffix:
Gender:F
Credentials:RN, BSN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 ROUTE 30 N
Mailing Address - Street 2:
Mailing Address - City:BOMOSEEN
Mailing Address - State:VT
Mailing Address - Zip Code:05732-9647
Mailing Address - Country:US
Mailing Address - Phone:802-468-5641
Mailing Address - Fax:802-468-2923
Practice Address - Street 1:275 ROUTE 30 N
Practice Address - Street 2:
Practice Address - City:BOMOSEEN
Practice Address - State:VT
Practice Address - Zip Code:05732-9647
Practice Address - Country:US
Practice Address - Phone:802-468-5641
Practice Address - Fax:802-468-2923
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-21
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0260019322163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator