Healthcare Provider Details

I. General information

NPI: 1073323275
Provider Name (Legal Business Name): SIERRA GENE TROY-REGIER CNM WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2025
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 CHRISTOPHER COLUMBUS DR
JERSEY CITY NJ
07302-5526
US

IV. Provider business mailing address

504 GRAND ST APT E23
NEW YORK NY
10002-4161
US

V. Phone/Fax

Practice location:
  • Phone: 201-451-6300
  • Fax:
Mailing address:
  • Phone: 646-209-9129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number95031049
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number236471
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: