Provider Demographics
NPI:1649510090
Name:REDDING, CAYCE L (NP)
Entity type:Individual
Prefix:
First Name:CAYCE
Middle Name:L
Last Name:REDDING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CAYCE
Other - Middle Name:
Other - Last Name:REDDING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:191 COUNTY ROAD 522
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834-7997
Mailing Address - Country:US
Mailing Address - Phone:662-643-7027
Mailing Address - Fax:
Practice Address - Street 1:6019 WALNUT GROVE RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2113
Practice Address - Country:US
Practice Address - Phone:662-772-2488
Practice Address - Fax:662-772-2890
Is Sole Proprietor?:No
Enumeration Date:2013-02-21
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR880089363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily