Provider Demographics
NPI:1275517559
Name:BATTLES, REGINA MARIA (APN)
Entity Type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:MARIA
Last Name:BATTLES
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MRS
Other - First Name:REGINA
Other - Middle Name:MARIA
Other - Last Name:SEIBUTIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:1530 N 7TH ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47807-1057
Mailing Address - Country:US
Mailing Address - Phone:812-238-4555
Mailing Address - Fax:812-238-4517
Practice Address - Street 1:1530 N 7TH ST
Practice Address - Street 2:SUITE 500
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47807-1057
Practice Address - Country:US
Practice Address - Phone:812-238-4555
Practice Address - Fax:812-238-4517
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209002944363L00000X
IN71002891A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q24892Medicare UPIN
ILK10600Medicare PIN