Provider Demographics
NPI:1255669529
Name:MOZINGO, REGINA NATTALIE (PMHNP-BC, ANP-C, DNP)
Entity Type:Individual
Prefix:MS
First Name:REGINA
Middle Name:NATTALIE
Last Name:MOZINGO
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Gender:F
Credentials:PMHNP-BC, ANP-C, DNP
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Mailing Address - Street 1:445 DOLLEY MADISON RD STE 410
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-5167
Mailing Address - Country:US
Mailing Address - Phone:336-292-1510
Mailing Address - Fax:336-292-0679
Practice Address - Street 1:445 DOLLEY MADISON RD STE 410
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-5167
Practice Address - Country:US
Practice Address - Phone:336-292-1510
Practice Address - Fax:336-292-0679
Is Sole Proprietor?:No
Enumeration Date:2009-11-25
Last Update Date:2020-07-27
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Provider Licenses
StateLicense IDTaxonomies
NC5004580363LA2200X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health