Individual
MRS. ANGELA MARIE REDDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1201 E 7TH ST, POWELL, WY 82435-2126
(307) 764-4107
Mailing address
1201 E 7TH ST, POWELL, WY 82435-2126
(307) 764-4107
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
531
WY
363A00000X
Physician Assistant
TL531
WY
363AM0700X
Medical Physician Assistant
MED-PAC-LIC-51041
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
531
WYOMING LICENSE
WY
01
—
TL531
TEMPORARY LICENSE NUMBER
WY
Enumeration date
10/11/2011
Last updated
12/08/2025
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