Healthcare Provider Details

I. General information

NPI: 1497952055
Provider Name (Legal Business Name): HILARI ALYSIA REAGIN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2007
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

467 W DOYLE ST
TOCCOA GA
30577-1791
US

IV. Provider business mailing address

467 W DOYLE ST
TOCCOA GA
30577-1791
US

V. Phone/Fax

Practice location:
  • Phone: 706-886-4673
  • Fax:
Mailing address:
  • Phone: 706-886-4673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN-NP205000
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP205000
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: