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General NPI Number Information
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NPI Number | 1356480883
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Entity Type | Individual
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Provider Name | REGINA K WELBORN CRNA
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Gender | Female
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 2051 HAMILL RD
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City | HIXSON
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State | TN
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Zip | 37343
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Country | US
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Telephone | 423-495-7100
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Fax | 423-624-6355
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Provider Business Mailing Address
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Address Line | PO BOX 535575
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City | ATLANTA
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State | GA
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Zip | 30353-5595
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Country | US
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Telephone | 865-342-8900
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Fax | 865-691-0843
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN80401
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APN12470
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License Number State | TN
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