Provider Demographics
NPI:1639566383
Name:REDDICK, CAROL G (APRN, CNM)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:G
Last Name:REDDICK
Suffix:
Gender:F
Credentials:APRN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 SEVEN HILLS DR STE 103
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4378
Mailing Address - Country:US
Mailing Address - Phone:725-777-0414
Mailing Address - Fax:702-565-5027
Practice Address - Street 1:870 SEVEN HILLS DR STE 103
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4378
Practice Address - Country:US
Practice Address - Phone:725-777-0414
Practice Address - Fax:702-565-5027
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-21
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9195584176B00000X
NVAPRN002892176B00000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife