Basic Information
| Provider Information | |||||||||
| NPI: | 1649510090 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REDDING | ||||||||
| FirstName: | CAYCE | ||||||||
| MiddleName: | L. | ||||||||
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| NameSuffix: | |||||||||
| Credential: | NP | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | REDDING | ||||||||
| OtherFirstName: | CAYCE | ||||||||
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| OtherCredential: | FNP-BC | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 191 COUNTY ROAD 522 | ||||||||
| Address2: | |||||||||
| City: | CORINTH | ||||||||
| State: | MS | ||||||||
| PostalCode: | 388347997 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6626437027 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6019 WALNUT GROVE RD | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381202113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6627722488 | ||||||||
| FaxNumber: | 6627722890 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2013 | ||||||||
| LastUpdateDate: | 04/16/2018 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | R880089 | MS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.