Provider Demographics
NPI:1285165274
Name:REDDINGER, NICOLE JOANNA (CPT)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:JOANNA
Last Name:REDDINGER
Suffix:
Gender:F
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2622 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-3967
Mailing Address - Country:US
Mailing Address - Phone:406-587-9679
Mailing Address - Fax:
Practice Address - Street 1:2622 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-3967
Practice Address - Country:US
Practice Address - Phone:406-587-9679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-22
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator