Healthcare Provider Details

I. General information

NPI: 1699645788
Provider Name (Legal Business Name): ASHLEY REDA CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2025
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8114 SANDPIPER CIR STE 100
NOTTINGHAM MD
21236-5901
US

IV. Provider business mailing address

105 RAVENSWOOD CT
JOPPA MD
21085-4526
US

V. Phone/Fax

Practice location:
  • Phone: 410-933-8101
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR191450
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: