Healthcare Provider Details

I. General information

NPI: 1942818398
Provider Name (Legal Business Name): REGAN ROWSON DNP, NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2020
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N BEAVER ST
FLAGSTAFF AZ
86001-3118
US

IV. Provider business mailing address

9630 N ALDRICH RD
FLAGSTAFF AZ
86004-1272
US

V. Phone/Fax

Practice location:
  • Phone: 928-773-2120
  • Fax:
Mailing address:
  • Phone: 619-602-3431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number246393
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License NumberRN161774
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: