Provider Demographics
NPI:1164799482
Name:KOWAL, REGINA M (NP)
Entity Type:Individual
Prefix:MS
First Name:REGINA
Middle Name:M
Last Name:KOWAL
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 1:165 UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-8900
Mailing Address - Country:US
Mailing Address - Phone:413-256-0421
Mailing Address - Fax:
Practice Address - Street 1:165 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-8900
Practice Address - Country:US
Practice Address - Phone:413-256-0421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-01
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3013950363LF0000X
PARN723616363LF0000X
MA213169363LF0000X
MARN213169363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily