Healthcare Provider Details

I. General information

NPI: 1255429593
Provider Name (Legal Business Name): KAREN C REGAN N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 CHURCH ST
CAMDEN NY
13316-1428
US

IV. Provider business mailing address

28 CHURCH ST
CAMDEN NY
13316-1428
US

V. Phone/Fax

Practice location:
  • Phone: 315-245-3192
  • Fax: 315-245-3195
Mailing address:
  • Phone: 315-245-3192
  • Fax: 315-245-3195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF330615-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: