Provider Demographics
NPI:1053530170
Name:REDD, DENISE KAREN (ARNP)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:KAREN
Last Name:REDD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3721 N MONROE ST
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-2740
Mailing Address - Country:US
Mailing Address - Phone:850-562-1128
Mailing Address - Fax:850-562-1871
Practice Address - Street 1:3721 N MONROE ST
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-2740
Practice Address - Country:US
Practice Address - Phone:850-562-1128
Practice Address - Fax:850-562-1871
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2524222363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily