DR. GWENDOLYN JACKSON REDIC (NPI# 1588188312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588188312 |
| Entity Type | Individual |
| Full Name | DR. GWENDOLYN JACKSON REDIC |
| Credential | DNP |
| Practice Address |
1647 Benning Rd Ne Ste 200 Washington DC 20002-4570 |
| Mailing Address |
Po Box 751461 Charlotte NC 28275-1461 |
| Practice Telephone | 2026842784 |
| Mailing Telephone | 8437926200 |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2019-01-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
APRN-21119 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1647 BENNING RD NE STE 200 |
| City | WASHINGTON |
| State | DC |
| Zip Code | 20002-4570 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841303880 | Edwin Charles Chapman Sr. | Internal Medicine | 1647 Benning Rd Ne Ste 200, Washington, DC 20002-4570 | 2006-08-16 |
| 1639503451 | Kambia Medical Services LLC | Clinic/Center | 1647 Benning Rd Ne Ste 200, Washington, DC 20002-4570 | 2013-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508484569 | Curative Labs Inc. | Clinical Medical Laboratory | 3330 New York Ave Ne, Washington, DC 20002 | 2020-07-07 |
| 1477174415 | Chuquita Alma Berry | Technician | 11 R Street Ne, Apt 204, Washington, DC 20002 | 2020-04-30 |
| 1891326104 | For Us Therapeutics Counseling & Consulting Services, LLC | Community/Behavioral Health | 1425 Hst, Ne, Washington, DC 20002 | 2020-01-27 |
| 1215574975 | Chanea Paige | Technician | 1753 A St Ne, Washington, DC 20002 | 2019-12-02 |
| 1861038952 | Yasmen Britt | Emergency Medical Technician, Paramedic | 1711 Benning Rd, Washington, DC 20002 | 2019-11-23 |
| 1871053165 | Alyse Marie Knuth | Dentist | Pentagon, Corridor 8, Washington, DC 20002 | 2019-03-22 |
| 1043776586 | Courtney Moore-mercado | Social Worker | 429 P Street Nw, Washington, DC 20002 | 2019-02-20 |
| 1578034096 | Triple Alliance Pharmacy, Inc | Pharmacy | 1819 West Virgnia Avenue Ne, Washington Dc, DC 20002 | 2018-12-10 |
| 1477023000 | Tekisha Cecelia Blake | Technician | 16 R Street Ne, Washington, DC 20002 | 2018-11-27 |
| 1801366497 | Tionna Paulette Harrison | Technician | 150 Q Street Ne 1427, Washington, DC 20002 | 2018-11-27 |
| Find all providers in zip 20002 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255973947 | Michael Allen Parsley | Nurse Practitioner | 110 Irving St Nw # At, Washington, DC 20010-3017 | 2019-10-14 |
| 1659927606 | Susan Thornton Oyola | Nurse Practitioner | 110 Irving St Nw Unit 3ne, Washington, DC 20010-3017 | 2019-08-15 |
| 1770055006 | Melanie Dawn Sims | Nurse Practitioner | 110 Irving St Nw # 4b-42, Washington, DC 20010-3017 | 2018-12-27 |
| 1396285680 | Jessica Jean Thurn | Nurse Practitioner | 201 I St Ne, Apt. 408, Washington, DC 20002-4449 | 2017-03-06 |
| 1790150688 | Polly Rebecca Jackson | Nurse Practitioner | 4875 N 4 Mile Rd, Washington, MO 63090-3931 | 2015-12-03 |
| 1437418563 | Alyson Severino | Nurse Practitioner | 110 Irving St Nw # 424b, Washington, DC 20010-3017 | 2012-05-09 |
| 1033340799 | Floyd Joseph Johnson IIi | Nurse Practitioner | 2131 K St Nw Ste 201, Washington, DC 20037-1856 | 2009-07-29 |
| 1073753224 | Latoya Michon Taylor | Nurse Practitioner | 2041 Georgia Ave Nw Towers 2322, Washington, DC 20060 | 2009-03-01 |
| 1427197888 | Anna Lisa Licud | Nurse Practitioner | 110 Irving St., Nw, Whc Surgical Critical Care Service Suite 4b-42, Washington, DC 20010-2975 | 2007-02-05 |
| 1376638866 | Amanda Champion Bunch | Nurse Practitioner | 1203 Carolina Ave, Washington, NC 27889-3571 | 2006-10-03 |
| Find all providers in WASHINGTON | ||||
| City | WASHINGTON |
| Zip Code | 20002 |
Please comment or provide details below to improve the information on DR. GWENDOLYN JACKSON REDIC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.