Provider Demographics
NPI:1508079534
Name:REEDY, REBECCA L (PA -C)
Entity Type:Individual
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First Name:REBECCA
Middle Name:L
Last Name:REEDY
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Gender:F
Credentials:PA -C
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Mailing Address - Street 1:2500 W UTOPIA RD
Mailing Address - Street 2:STE. 100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-4171
Mailing Address - Country:US
Mailing Address - Phone:602-214-6148
Mailing Address - Fax:602-214-6149
Practice Address - Street 1:5859 W TALAVI BLVD
Practice Address - Street 2:SUITE 165
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-1869
Practice Address - Country:US
Practice Address - Phone:602-548-7800
Practice Address - Fax:602-548-0006
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2013-09-24
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Provider Licenses
StateLicense IDTaxonomies
AZ3316363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant