Healthcare Provider Details

I. General information

NPI: 1902211204
Provider Name (Legal Business Name): ASHLEY E REGAL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2014
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 E NORTHFIELD DR STE A
BROWNSBURG IN
46112-2210
US

IV. Provider business mailing address

475 E NORTHFIELD DR STE A
BROWNSBURG IN
46112-2210
US

V. Phone/Fax

Practice location:
  • Phone: 317-286-3147
  • Fax:
Mailing address:
  • Phone: 317-286-3147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number71004932A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: