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General NPI Number Information
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NPI Number | 1427684562
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Entity Type | Individual
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Provider Name | DERICK STEVEN REEDY PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 03/20/2020
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Last Update Date | 06/21/2025
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Provider Practice Location Address
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Address Line | 11708 NICKELSVILLE HWY STE 2
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City | NICKELSVILLE
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State | VA
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Zip | 24271-2872
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Country | US
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Telephone | 276-248-1880
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Fax | 276-258-0616
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Provider Business Mailing Address
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Address Line | PO BOX 270
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City | NICKELSVILLE
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State | VA
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Zip | 24271-0270
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Country | US
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Telephone | 276-258-1880
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Fax | 276-258-0616
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 210678
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 3014893
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 27352
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0024181231
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License Number State | VA
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