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NPI Code Detail

MEDICARE: REGINA R SIBAL PMHNP-BC

MEDICARE: REGINA R SIBAL PMHNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner0024164067VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255311965
Entity Type Code : Individual
Provider Name (Legal Business Name) : REGINA R SIBAL PMHNP-BC
Provider Business Mailing Address
First Line : 4310 METRO PKWY STE 205
Second Line :
City : FORT MYERS
State : FL
Zip : 33916-9416
Country : US
Telephone Number : 239-690-6906
Fax Number :
Provider Business Practice Location Address
First Line : 4410 CLAIBORNE SQ E STE 334
Second Line :
City : HAMPTON
State : VA
Zip : 23666-2074
Country : US
Telephone Number : 757-606-1377
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2006
Last Update Date : 12/18/2025

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