Healthcare Provider Details

I. General information

NPI: 1841259272
Provider Name (Legal Business Name): REGINA LYNN WOODS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REGINA LYNN TAYLOR APRN

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 07/18/2023
Certification Date: 07/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 HEREFORD CURVE ROAD
JAMESTOWN KY
42629
US

IV. Provider business mailing address

PO BOX 1080
BURKESVILLE KY
42717-1080
US

V. Phone/Fax

Practice location:
  • Phone: 270-343-2551
  • Fax: 606-679-4782
Mailing address:
  • Phone: 270-858-6655
  • Fax: 270-858-4607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3530P
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3003530
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: