Individual
JENNIFER YVETTE REDDICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
3985 SHARON SPGS, POWDER SPRINGS, GA 30127-2846
(786) 431-7637
Mailing address
3985 SHARON SPGS, POWDER SPRINGS, GA 30127-2846
(786) 431-7637
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN210487
GA
363LA2200X
Adult Health Nurse Practitioner
RN210487
GA
Other
Enumeration date
11/29/2020
Last updated
12/10/2022
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