Provider Demographics
NPI:1235473091
Name:EPP, REGINA (FNP)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:EPP
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35900 BOB HOPE DR
Mailing Address - Street 2:SUITE 230
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-1766
Mailing Address - Country:US
Mailing Address - Phone:760-324-2800
Mailing Address - Fax:760-324-2811
Practice Address - Street 1:35900 BOB HOPE DR
Practice Address - Street 2:SUITE 230
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-1766
Practice Address - Country:US
Practice Address - Phone:760-324-2800
Practice Address - Fax:760-324-2811
Is Sole Proprietor?:No
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21135363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner