Provider Demographics
NPI:1871879171
Name:CAPPELLE, REGINA TORENE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:TORENE
Last Name:CAPPELLE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:REGINA
Other - Middle Name:TORENE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:4420 IRVING BLVD NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-5915
Mailing Address - Country:US
Mailing Address - Phone:505-727-6300
Mailing Address - Fax:505-727-9590
Practice Address - Street 1:4420 IRVING BLVD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-5915
Practice Address - Country:US
Practice Address - Phone:505-727-6300
Practice Address - Fax:505-727-9590
Is Sole Proprietor?:No
Enumeration Date:2011-10-31
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-01861363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM57889368Medicaid
NMCNP-01861OtherNM LICENSE