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General NPI Number Information
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NPI Number | 1083122386
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Entity Type | Individual
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Provider Name | REGINA RADOGNA CRNP
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Gender | Female
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Dates
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Enumeration Date | 01/21/2018
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 3416 POOLE RD STE 120
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City | RALEIGH
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State | NC
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Zip | 27610-2918
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Country | US
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Telephone | 919-902-7366
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 746724
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City | ATLANTA
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State | GA
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Zip | 30374-6724
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Country | US
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Telephone | 773-352-1515
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP018518
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5022431
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License Number State | NC
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