Provider Demographics
NPI:1083122386
Name:RADOGNA, REGINA (CRNP)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:RADOGNA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2461 NAZARETH RD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-2743
Mailing Address - Country:US
Mailing Address - Phone:610-253-5800
Mailing Address - Fax:610-258-5138
Practice Address - Street 1:2461 NAZARETH RD
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045
Practice Address - Country:US
Practice Address - Phone:610-258-5300
Practice Address - Fax:610-258-5138
Is Sole Proprietor?:No
Enumeration Date:2018-01-21
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP018518363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner