Provider Demographics
NPI:1750373163
Name:REDDY, NALLU HEMALATHA (MD)
Entity type:Individual
Prefix:MRS
First Name:NALLU
Middle Name:HEMALATHA
Last Name:REDDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3801 DR MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64130-2807
Mailing Address - Country:US
Mailing Address - Phone:816-922-7645
Mailing Address - Fax:816-448-2980
Practice Address - Street 1:3801 DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64130-2807
Practice Address - Country:US
Practice Address - Phone:816-922-7645
Practice Address - Fax:816-448-2980
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-244492084P0800X
MO1051112084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO206983108Medicaid
B680000Medicare ID - Type UnspecifiedGROUP NUMBER
MO206983108Medicaid