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NPI Code Detail

MEDICARE: REGINE G VINCENT NP

MEDICARE: REGINE G VINCENT NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP2300XPrimary Care Nurse PractitionerRN180691GA

General Provider Information

NPI Number : 1346800257
Entity Type Code : Individual
Provider Name (Legal Business Name) : REGINE G VINCENT NP
Provider Business Mailing Address
First Line : 3750 PEACHTREE RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30319-1385
Country : US
Telephone Number : 404-261-6611
Fax Number :
Provider Business Practice Location Address
First Line : 3750 PEACHTREE RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30319-1385
Country : US
Telephone Number : 404-261-6611
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2019
Last Update Date : 06/13/2019

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