Redwine, Karen M

Redwine, Karen M is an individual health care provider with primary practice located at 305 E Jefferson St , Boise ID 83712-6273. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Nephrology. Allopathic & Osteopathic Physicians / Pediatric Nephrology is her primary health care specialty. Redwine, Karen M can be contacted via phone (208) 381-7336.

Contact Information

Primary practice address
305 E Jefferson St Boise ID 83712-6273
Phone: (208) 381-7336
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X M0173 Texas
Allopathic & Osteopathic Physicians / Pediatric Nephrology 2080P0210X E-5176 Arkansas
Allopathic & Osteopathic Physicians / Pediatric Nephrology 2080P0210X M0173 Texas
Allopathic & Osteopathic Physicians / Pediatric Nephrology 2080P0210X M-13200 Idaho

Profile Details

NPI number 1164476131
LBN Legal business name Redwine, Karen M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 22nd, 2006
Last updated Sep 3rd, 2019 - about 6 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 1164476131 NPPES
Arkansas MEDICAID 164436001
Arkansas MEDICAID 180864401
Arkansas Other 8P2608
Arkansas Other 180864402

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