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NPI Code Detail

MEDICARE: MRS. LAURIE K REDDING P.A.-C

MEDICARE:  MRS. LAURIE K REDDING  P.A.-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant1297CO

General Provider Information

NPI Number : 1619144888
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAURIE K REDDING P.A.-C
Provider Business Mailing Address
First Line : 7605 POTOMAC DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80920-8027
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2130 HOLLOW BROOK DR
Second Line : SUITE 100
City : COLORADO SPRINGS
State : CO
Zip : 80918-8400
Country : US
Telephone Number : 719-590-7007
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2008
Last Update Date : 05/16/2008

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Directions to “ MRS. LAURIE K REDDING P.A.-C” Practice Location

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