Healthcare Provider Details

I. General information

NPI: 1487399796
Provider Name (Legal Business Name): REGAN CLARESSE SILVIS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2022
Last Update Date: 05/02/2022
Certification Date: 05/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W 8TH AVE
YUMA CO
80759-2641
US

IV. Provider business mailing address

8633 MOSS CT
ANCHORAGE AK
99504-2927
US

V. Phone/Fax

Practice location:
  • Phone: 970-848-5405
  • Fax:
Mailing address:
  • Phone: 907-351-0150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00006931
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHAP160158
License Number StateAK
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHA.0020278
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: