MEDICARE: REGINA DAWN HAIGHT APRN

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
1	364SP0808X	Psychiatric/Mental Health Clinical Nurse Specialist	71002536A	IN

General Provider Information

NPI Number	:	1407014327
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REGINA DAWN HAIGHT APRN

Provider Business Mailing Address
First Line	:	1701 N CAPITOL AVE
Second Line	:	C-3
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-1203
Country	:	US
Telephone Number	:	317-962-0892
Fax Number	:	317-962-6322

Provider Business Practice Location Address
First Line	:	1701 N CAPITOL AVE
Second Line	:	C-3
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-1203
Country	:	US
Telephone Number	:	317-962-0892
Fax Number	:	317-962-6322

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/28/2008
Last Update Date	:	05/28/2008

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