Healthcare Provider Details

I. General information

NPI: 1346931722
Provider Name (Legal Business Name): REGAN SELLERS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2023
Last Update Date: 05/17/2023
Certification Date: 05/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5454 WOLF RUN DR
COLUMBUS OH
43230-4527
US

IV. Provider business mailing address

5454 WOLF RUN DR
COLUMBUS OH
43230-4527
US

V. Phone/Fax

Practice location:
  • Phone: 614-378-4806
  • Fax:
Mailing address:
  • Phone: 614-378-4806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number470750
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code364SH0200X
TaxonomyHome Health Clinical Nurse Specialist
License Number470750
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code364SM0705X
TaxonomyMedical-Surgical Clinical Nurse Specialist
License Number470750
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code364SR0400X
TaxonomyRehabilitation Clinical Nurse Specialist
License Number470750
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: