Provider Demographics
NPI:1174865869
Name:RILEY, REGAN ELIZABETH (DO)
Entity Type:Individual
Prefix:
First Name:REGAN
Middle Name:ELIZABETH
Last Name:RILEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 UNSER BLVD SE STE 28400
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-3392
Mailing Address - Country:US
Mailing Address - Phone:505-253-3000
Mailing Address - Fax:
Practice Address - Street 1:2400 UNSER BLVD SE STE 28400
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-3392
Practice Address - Country:US
Practice Address - Phone:505-253-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-21
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA2032-17207V00000X
NMA203217207V00000X
NMA-2032-17207VC0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VC0300XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyComplex Family Planning
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology