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General NPI Number Information
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NPI Number | 1164970216
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Entity Type | Individual
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Provider Name | REGINA ANN PREWITT APRN
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Gender | Female
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Dates
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Enumeration Date | 09/19/2016
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Last Update Date | 01/13/2017
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Provider Practice Location Address
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Address Line | 407 SHOPPERS DR
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City | WINCHESTER
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State | KY
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Zip | 40391-1380
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Country | US
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Telephone | 859-744-9866
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Fax |
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Provider Business Mailing Address
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Address Line | 4743 MCCORMICK RD
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City | MOUNT STERLING
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State | KY
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Zip | 40353-8931
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Country | US
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Telephone | 859-585-8663
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3010263
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License Number State | KY
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