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General NPI Number Information
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NPI Number | 1871743252
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Entity Type | Individual
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Provider Name | KATHERINE ELIZABETH REDDISH PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/23/2008
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 3135 SPRINGBANK LN STE 140
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City | CHARLOTTE
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State | NC
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Zip | 28226-3363
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Country | US
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Telephone | 704-702-6555
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Fax |
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Provider Business Mailing Address
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Address Line | 3135 SPRINGBANK LN STE 140
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City | CHARLOTTE
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State | NC
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Zip | 28226-3363
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Country | US
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Telephone | 704-702-6555
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Fax | 704-270-6221
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-01542
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License Number State | NC
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