Provider Demographics
NPI:1275895914
Name:LUBERTI, REGINA VERONICA (CRNP FNP-BC)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:VERONICA
Last Name:LUBERTI
Suffix:
Gender:F
Credentials:CRNP FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 AMOSLAND RD
Mailing Address - Street 2:
Mailing Address - City:MORTON
Mailing Address - State:PA
Mailing Address - Zip Code:19070-1121
Mailing Address - Country:US
Mailing Address - Phone:484-680-4921
Mailing Address - Fax:
Practice Address - Street 1:17 AMOSLAND RD
Practice Address - Street 2:
Practice Address - City:MORTON
Practice Address - State:PA
Practice Address - Zip Code:19070-1121
Practice Address - Country:US
Practice Address - Phone:484-680-4921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-08
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP007623363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily