Healthcare Provider Details

I. General information

NPI: 1760229470
Provider Name (Legal Business Name): KATHLEEN REDDING RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2024
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

459 PATTERSON RD
HONOLULU HI
96819-1522
US

IV. Provider business mailing address

1040 LUNALILO ST APT 101
HONOLULU HI
96822-5718
US

V. Phone/Fax

Practice location:
  • Phone: 808-285-2925
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN3053432
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: