Provider Demographics
NPI:1194120766
Name:REDING, KELSEY (FNP/PMHNP)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:REDING
Suffix:
Gender:
Credentials:FNP/PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2568 BECKER RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IL
Mailing Address - Zip Code:62249-3038
Mailing Address - Country:US
Mailing Address - Phone:618-920-7094
Mailing Address - Fax:
Practice Address - Street 1:2568 BECKER RD
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IL
Practice Address - Zip Code:62249-3038
Practice Address - Country:US
Practice Address - Phone:618-920-7094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-25
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277.002817363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily