Healthcare Provider Details

I. General information

NPI: 1144506866
Provider Name (Legal Business Name): REGINA MARIE HANNA APN, CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2011
Last Update Date: 10/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 WEST BLACKWELL STREET SAINT CLARE'S HOSPITAL 3RD FLOOR
DOVER NJ
07801-2525
US

IV. Provider business mailing address

400 WEST BLACKWELL STREET SAINT CLARE'S HOSPITAL 3RD FLOOR
DOVER NJ
07801-2525
US

V. Phone/Fax

Practice location:
  • Phone: 973-989-3613
  • Fax: 973-989-3040
Mailing address:
  • Phone: 973-989-3613
  • Fax: 973-989-3040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number26NC07337900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: