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General NPI Number Information
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NPI Number | 1144689506
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Entity Type | Individual
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Provider Name | REGINA M REYES CRNP
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Gender | Female
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Dates
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Enumeration Date | 02/14/2016
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Last Update Date | 07/09/2021
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Provider Practice Location Address
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Address Line | 5601 LOCH RAVEN BLVD
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City | BALTIMORE
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State | MD
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Zip | 21239-2945
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Country | US
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Telephone | 443-444-4485
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Fax |
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Provider Business Mailing Address
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Address Line | 5601 LOCH RAVEN BLVD
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City | BALTIMORE
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State | MD
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Zip | 21239-2945
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Country | US
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Telephone | 443-444-4485
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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 | 0024177645
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | AC001693
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AC001693
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License Number State | MD
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