Provider Demographics
NPI:1407133689
Name:REDDING, LYNN WELBORN (RPH)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:WELBORN
Last Name:REDDING
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 N ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-4073
Mailing Address - Country:US
Mailing Address - Phone:305-292-9833
Mailing Address - Fax:
Practice Address - Street 1:2805 N ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-4073
Practice Address - Country:US
Practice Address - Phone:305-292-9833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS37701183500000X
NC7075183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist