Provider Demographics
NPI:1447823091
Name:MICHAEL, REGINA N (NP)
Entity type:Individual
Prefix:MS
First Name:REGINA
Middle Name:N
Last Name:MICHAEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 ALABAMA AVE SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-4542
Mailing Address - Country:US
Mailing Address - Phone:202-292-5746
Mailing Address - Fax:202-561-6977
Practice Address - Street 1:1100 ALABAMA AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-4542
Practice Address - Country:US
Practice Address - Phone:202-292-5746
Practice Address - Fax:202-561-6977
Is Sole Proprietor?:No
Enumeration Date:2021-07-21
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN65891363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health