Provider Demographics
NPI:1083120273
Name:REDDY, BRIANNA (PA-C)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:REDDY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5844 NW BARRY RD STE 270
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64154-1466
Mailing Address - Country:US
Mailing Address - Phone:816-880-6238
Mailing Address - Fax:816-880-2770
Practice Address - Street 1:5844 NW BARRY RD STE 270
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64154-1466
Practice Address - Country:US
Practice Address - Phone:816-880-6238
Practice Address - Fax:816-880-2770
Is Sole Proprietor?:No
Enumeration Date:2017-12-26
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10002415A363AM0700X
MO2023015103363AM0700X
PAMA061603363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical