Provider Demographics
NPI:1225198997
Name:REDDING, SUSAN R (FNP C)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:R
Last Name:REDDING
Suffix:
Gender:F
Credentials:FNP C
Other - Prefix:MISS
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:ROMANOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:601 S ELM ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858
Mailing Address - Country:US
Mailing Address - Phone:252-758-7292
Mailing Address - Fax:252-847-7096
Practice Address - Street 1:P H COUNTY MEMORIAL HOSPITAL
Practice Address - Street 2:2100 STANTONSBURG RD
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27835-6028
Practice Address - Country:US
Practice Address - Phone:252-847-0868
Practice Address - Fax:252-847-7096
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC054753363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner