Provider Demographics
NPI:1871078444
Name:REDONDO, JAMIE AARON GARRETT (MSN/FNP-C)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:AARON GARRETT
Last Name:REDONDO
Suffix:
Gender:F
Credentials:MSN/FNP-C
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:AARON
Other - Last Name:GARRETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN/FNP-C
Mailing Address - Street 1:705 BENDER CT
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-7692
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:705 BENDER CT
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-7692
Practice Address - Country:US
Practice Address - Phone:559-936-1852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-30
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95010165363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner