Redfearn, Mary D

Redfearn, Mary D is an individual health care provider with primary practice located at 3229 Bear Run Blvd Bldg B , Orange Park FL 32065-7334. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology. Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology is her primary health care specialty. Redfearn, Mary D can be contacted via phone (904) 272-3177.

Contact Information

Primary practice address
3229 Bear Run Blvd Bldg B Orange Park FL 32065-7334
Phone: (904) 272-3177
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X ARNP485802 Florida
Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology 363LX0001X ARNP485802 Florida

Profile Details

NPI number 1215001896
LBN Legal business name Redfearn, Mary D
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 17th, 2006
Last updated Dec 21st, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215001896 NPPES
Florida MEDICAID 034577600

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