Healthcare Provider Details

I. General information

NPI: 1295966398
Provider Name (Legal Business Name): BETH A REDDEN CNM, APRN, FACNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2009
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 WASHINGTON ST W STE 201
CHARLESTON WV
25302-2344
US

IV. Provider business mailing address

108 WASHINGTON ST W STE 201
CHARLESTON WV
25302-2344
US

V. Phone/Fax

Practice location:
  • Phone: 304-345-2999
  • Fax: 304-345-2235
Mailing address:
  • Phone: 304-345-2999
  • Fax: 304-345-2235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPRN61710
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: