Healthcare Provider Details

I. General information

NPI: 1619622255
Provider Name (Legal Business Name): HALI REDDING PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2022
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 E CHURCH ST
LEWISBURG TN
37091-2851
US

IV. Provider business mailing address

3024 BUSINESS PARK CIR
GOODLETTSVILLE TN
37072-3132
US

V. Phone/Fax

Practice location:
  • Phone: 615-814-0885
  • Fax: 615-814-0056
Mailing address:
  • Phone: 615-239-2018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5065
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: