Provider Demographics
NPI:1477433506
Name:REDDING, KAMIAH WYNN (FNP-C)
Entity type:Individual
Prefix:
First Name:KAMIAH
Middle Name:WYNN
Last Name:REDDING
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15067 LELAND CIR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-8670
Mailing Address - Country:US
Mailing Address - Phone:850-363-2809
Mailing Address - Fax:850-363-2809
Practice Address - Street 1:2639 N MONROE ST STE 100
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-4073
Practice Address - Country:US
Practice Address - Phone:850-363-2809
Practice Address - Fax:850-363-2809
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9369655363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty