MEDICARE: MS. REGINA C MASON CRNP

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
1	363LG0600X	Gerontology Nurse Practitioner	VP003969H	PA

General Provider Information

NPI Number	:	1619992922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. REGINA C MASON CRNP

Provider Business Mailing Address
First Line	:	102 WOODMONT BLVD STE 600
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37205-5250
Country	:	US
Telephone Number	:	888-987-1151
Fax Number	:

Provider Business Practice Location Address
First Line	:	2201 W OREGON AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19145-4142
Country	:	US
Telephone Number	:	215-623-1402
Fax Number	:	888-355-6726

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	02/10/2026

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