Healthcare Provider Details

I. General information

NPI: 1265970685
Provider Name (Legal Business Name): REGINA T. GELINAS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2017
Last Update Date: 02/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 N SALISBURY BLVD
SALISBURY MD
21801-2138
US

IV. Provider business mailing address

2425 N SALISBURY BLVD
SALISBURY MD
21801-2138
US

V. Phone/Fax

Practice location:
  • Phone: 877-222-4934
  • Fax: 443-944-0192
Mailing address:
  • Phone: 877-222-4934
  • Fax: 443-944-0192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR195507
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: