Healthcare Provider Details

I. General information

NPI: 1497352595
Provider Name (Legal Business Name): MARGARET ANN REGNERY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2020
Last Update Date: 10/02/2020
Certification Date: 10/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 ISLAND PARK DR STE 104
DANIEL ISLAND SC
29492-7560
US

IV. Provider business mailing address

1601 MARSH HARBOR LN UNIT 300
MT PLEASANT SC
29464-5537
US

V. Phone/Fax

Practice location:
  • Phone: 843-264-7973
  • Fax:
Mailing address:
  • Phone: 843-991-3353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number24019
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: