Provider Demographics
NPI:1093792384
Name:REDDINGTON, HOPE E (PA)
Entity Type:Individual
Prefix:
First Name:HOPE
Middle Name:E
Last Name:REDDINGTON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:HOPE
Other - Middle Name:E
Other - Last Name:WEGERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:333 E CAMPUS MALL
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53715-1365
Mailing Address - Country:US
Mailing Address - Phone:608-265-4904
Mailing Address - Fax:608-262-0674
Practice Address - Street 1:333 E CAMPUS MALL
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53715-1365
Practice Address - Country:US
Practice Address - Phone:608-265-4904
Practice Address - Fax:608-262-0674
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI934-023363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42966100Medicaid
WI42966100Medicaid
WI0035Medicare ID - Type Unspecified