Healthcare Provider Details

I. General information

NPI: 1760329478
Provider Name (Legal Business Name): MICHELLE RADLE REDDIN DNP, FNP-BC, APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 PFLAUM RD
MADISON WI
53716-2167
US

IV. Provider business mailing address

1112 ELIZABETH ST
MADISON WI
53703-1606
US

V. Phone/Fax

Practice location:
  • Phone: 608-204-3621
  • Fax: 608-237-0053
Mailing address:
  • Phone: 608-333-1744
  • Fax: 608-237-0053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LS0200X
TaxonomySchool Nurse Practitioner
License Number11321-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: