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General NPI Number Information
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NPI Number | 1730675612
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Entity Type | Individual
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Provider Name | REGAN RONEY FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/03/2018
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Last Update Date | 01/20/2021
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Provider Practice Location Address
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Address Line | 1430 JEFFERSON ST
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City | LAUREL
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State | MS
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Zip | 39440-4243
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Country | US
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Telephone | 601-425-2273
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 247
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City | LAUREL
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State | MS
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Zip | 39441-0247
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Country | US
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Telephone | 601-425-7550
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Fax | 601-399-6184
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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 | 902779
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License Number State | MS
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