Provider Demographics
NPI:1659967586
Name:REDDING, VANETTA
Entity Type:Individual
Prefix:
First Name:VANETTA
Middle Name:
Last Name:REDDING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26061 CAMBRIDGE LN APT 203
Mailing Address - Street 2:
Mailing Address - City:WARRENSVILLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44128-5804
Mailing Address - Country:US
Mailing Address - Phone:216-512-4896
Mailing Address - Fax:
Practice Address - Street 1:6500 PEARL RD
Practice Address - Street 2:
Practice Address - City:PARMA HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3813
Practice Address - Country:US
Practice Address - Phone:440-317-4070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide