Benjamin Reddick, Nicole Denae

Benjamin Reddick, Nicole Denae is an individual health care provider with primary practice located at 100 Theda Clark Medical Plz Ste 340 , Neenah WI 54956-2763. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Benjamin Reddick, Nicole Denae can be contacted via phone (920) 364-3600.

Contact Information

Primary practice address
100 Theda Clark Medical Plz Ste 340 Neenah WI 54956-2763
Phone: (920) 364-3600
Fax: (920) 364-3900
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA04542 Texas

Profile Details

NPI number 1659383040
LBN Legal business name Benjamin Reddick, Nicole Denae
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 13th, 2006
Last updated Mar 4th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659383040 NPPES
Texas Other 8Y0227 BCBS

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