Healthcare Provider Details

I. General information

NPI: 1003505876
Provider Name (Legal Business Name): BIANCA REGAN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2023
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 WESCOTT DR STE 304
FLEMINGTON NJ
08822-4600
US

IV. Provider business mailing address

215 STATE ROUTE 31 RM 116
FLEMINGTON NJ
08822-5752
US

V. Phone/Fax

Practice location:
  • Phone: 908-788-4022
  • Fax:
Mailing address:
  • Phone: 908-284-1125
  • Fax: 908-284-2016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number26NJ01470400
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ01470400
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number26NJ01470400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: