Healthcare Provider Details

I. General information

NPI: 1932637634
Provider Name (Legal Business Name): REGINA PLOHAL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2017
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10210 HICKORYWOOD HILL AVE STE 200
HUNTERSVILLE NC
28078-3417
US

IV. Provider business mailing address

10210 HICKORYWOOD HILL AVE STE 200
HUNTERSVILLE NC
28078-3417
US

V. Phone/Fax

Practice location:
  • Phone: 704-931-3375
  • Fax: 704-601-7808
Mailing address:
  • Phone: 704-931-3376
  • Fax: 704-601-7808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number116288
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5011197
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: