Provider Demographics
NPI:1689984452
Name:REDDEN, CHRISTOPHER BRAD (NP)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:BRAD
Last Name:REDDEN
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9912 ROCKWELL TERRACE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162
Mailing Address - Country:US
Mailing Address - Phone:405-990-5072
Mailing Address - Fax:
Practice Address - Street 1:1900 S COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:EL RENO
Practice Address - State:OK
Practice Address - Zip Code:73036-5427
Practice Address - Country:US
Practice Address - Phone:405-295-2900
Practice Address - Fax:405-295-2905
Is Sole Proprietor?:No
Enumeration Date:2010-10-14
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK76189363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily