Provider Demographics
NPI:1295966398
Name:REDDEN, BETH A (CNM, APRN, FACNM)
Entity type:Individual
Prefix:MRS
First Name:BETH
Middle Name:A
Last Name:REDDEN
Suffix:
Gender:F
Credentials:CNM, APRN, FACNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 RANDOLPH DR
Mailing Address - Street 2:
Mailing Address - City:DANIELS
Mailing Address - State:WV
Mailing Address - Zip Code:25832-9569
Mailing Address - Country:US
Mailing Address - Phone:304-616-7718
Mailing Address - Fax:
Practice Address - Street 1:97 GREAT TEAYS BLVD STE 6
Practice Address - Street 2:
Practice Address - City:SCOTT DEPOT
Practice Address - State:WV
Practice Address - Zip Code:25560-9816
Practice Address - Country:US
Practice Address - Phone:304-757-6999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN61710367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife