=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215879200
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | REGINA HAMILTON CROCHERON
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/08/2026
-----------------------------------------------------
Last Update Date | 04/08/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 126 WOODLAND AVE APT A
-----------------------------------------------------
City | SHELBY
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28152-7791
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-755-7449
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 126 WOODLAND AVE APT A
-----------------------------------------------------
City | SHELBY
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28152-7791
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-755-7449
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WS0200X
-----------------------------------------------------
Taxonomy Name | School Registered Nurse
-----------------------------------------------------
License Number | 297236
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------