Provider Demographics
NPI:1306380035
Name:REGAN, ASHLEY ERIN (LMT, RN)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:ERIN
Last Name:REGAN
Suffix:
Gender:F
Credentials:LMT, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 E BUTLER AVE
Mailing Address - Street 2:LL-04
Mailing Address - City:NEW BRITAIN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-5278
Mailing Address - Country:US
Mailing Address - Phone:267-640-7488
Mailing Address - Fax:
Practice Address - Street 1:350 E BUTLER AVE
Practice Address - Street 2:LL-04
Practice Address - City:NEW BRITAIN
Practice Address - State:PA
Practice Address - Zip Code:18901-5278
Practice Address - Country:US
Practice Address - Phone:267-640-7488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-14
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN630987163W00000X
PAMSG006734225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No163W00000XNursing Service ProvidersRegistered Nurse