Provider Demographics
NPI:1417849902
Name:REDDING, SHELBY JEAN (PA)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:JEAN
Last Name:REDDING
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:SHELBY
Other - Middle Name:JEAN
Other - Last Name:PIPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14455 W VAN BUREN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-9209
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14262 BAILEY RD
Practice Address - Street 2:
Practice Address - City:BAILEY
Practice Address - State:MI
Practice Address - Zip Code:49303-9763
Practice Address - Country:US
Practice Address - Phone:231-903-5864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant