Provider Demographics
NPI:1043692544
Name:REGAN, ANNA ALICIA (RN)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:ALICIA
Last Name:REGAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:ALICIA
Other - Last Name:GAPSTUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:94 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-3146
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:94 MAIN ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3146
Practice Address - Country:US
Practice Address - Phone:508-771-9599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2266418163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health