MS. RENEE JODELLE PRADDY NP NPI 1033707732

NPI Information

  • NPI: 1033707732
  • Provider Name: MS. RENEE JODELLE PRADDY, NP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • Address: 22002 108TH AVE
    QUEENS VILLAGE, NY
    ZIP 11429
  • Phone: (718) 812-8494

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NPI Details

MS. Renee Jodelle Praddy, NP is a family nurse practitioner in Queens Village, NY. MS. Renee Jodelle Praddy, NP NPI is 1033707732. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

22002 108TH AVE
QUEENS VILLAGE, NY
ZIP 11429-437
Phone: (718) 812-8494

The enumeration date for this NPI number is 1/7/2021 and was last updated on 1/7/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily346030NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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