Provider Demographics
NPI:1598139644
Name:REDDICK, SHERICE (ARNP)
Entity Type:Individual
Prefix:
First Name:SHERICE
Middle Name:
Last Name:REDDICK
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13612 LARAWAY DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33579-7136
Mailing Address - Country:US
Mailing Address - Phone:917-582-5596
Mailing Address - Fax:
Practice Address - Street 1:4572 N HIATUS RD
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-7987
Practice Address - Country:US
Practice Address - Phone:954-578-4000
Practice Address - Fax:954-578-4948
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-30
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9334557363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily