Provider Demographics
NPI:1871205740
Name:REDING, RENEE LYNN (AGPCNP)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:LYNN
Last Name:REDING
Suffix:
Gender:F
Credentials:AGPCNP
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:LYNN
Other - Last Name:ABT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AGPCNP
Mailing Address - Street 1:ELM AND CARLTON ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14263-0001
Mailing Address - Country:US
Mailing Address - Phone:716-845-2000
Mailing Address - Fax:
Practice Address - Street 1:ELM AND CARLTON ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14263-9623
Practice Address - Country:US
Practice Address - Phone:716-845-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF311155-01363L00000X
NY2022057229363LG0600X
NY2022027229363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology