Doctor Name: | KIMBERLY REDDICK |
NPI Number: | 1023239670 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | PN260137L |
Business Practice Address: | 2250 Hickory Road Suite 240 Plymouth Meeting, PA - 19462 |
Business Phone Number: | 6108341122 |
Business Fax Number: | 6108347525 |
Mailing Address: | 68 Wahl Street, DOUGLASSVILLE |
State: | PA |
Postal Code: | 19518 |
Phone Number: | 6104042767 |
Fax Number: | |
NPI Enumeration Date: | 05/01/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 164W00000X |
License Number: | PN260137L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Licensed Practical Nurse |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |