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General NPI Number Information
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NPI Number | 1619169752
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Entity Type | Individual
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Provider Name | REGINA EDAMWEN IYAWE APRN FNP-BC PMHNP BC
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Gender | Female
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Dates
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Enumeration Date | 08/13/2007
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Last Update Date | 02/26/2026
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Provider Practice Location Address
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Address Line | 1105 MEMORIAL DR STE 101
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City | DENISON
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State | TX
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Zip | 75020-2043
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Country | US
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Telephone | 214-440-7151
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Fax | 866-268-1244
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Provider Business Mailing Address
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Address Line | 1105 MEMORIAL DR STE 101
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City | DENISON
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State | TX
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Zip | 75020-2043
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Country | US
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Telephone | 214-440-7151
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Fax | 844-837-1906
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1056729
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP61298310
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License Number State | WA
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