Healthcare Provider Details

I. General information

NPI: 1588011050
Provider Name (Legal Business Name): REGENIA DURWOOD HUTCHINS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2016
Last Update Date: 03/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2691 FREDONIA RD
THOMASVILLE GA
31757-1038
US

IV. Provider business mailing address

500 GORDON AVE
THOMASVILLE GA
31792-6646
US

V. Phone/Fax

Practice location:
  • Phone: 229-221-8369
  • Fax:
Mailing address:
  • Phone: 229-233-8315
  • Fax: 229-233-0412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN073692
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: