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General NPI Number Information
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NPI Number | 1629024799
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Entity Type | Individual
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Provider Name | KRISTIN ANN REGAN AUD
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Gender | Female
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 10/13/2022
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Provider Practice Location Address
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Address Line | 2136 ROBINSON RD STE 3
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City | JACKSON
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State | MI
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Zip | 49203
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Country | US
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Telephone | 517-962-5063
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Fax | 517-962-5209
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Provider Business Mailing Address
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Address Line | 1410 W GANSON ST
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City | JACKSON
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State | MI
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Zip | 49202-4063
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Country | US
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Telephone | 517-962-5063
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Fax | 517-962-5209
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 1601000314
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License Number State | MI
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