Provider Demographics
NPI:1346511540
Name:BROWN, REGINA MARIE (RN)
Entity Type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:MARIE
Last Name:BROWN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:REGINA
Other - Middle Name:MARIE
Other - Last Name:IGLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:54 SAND CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-1899
Mailing Address - Country:US
Mailing Address - Phone:518-482-0464
Mailing Address - Fax:518-482-0129
Practice Address - Street 1:54 SAND CREEK RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-1899
Practice Address - Country:US
Practice Address - Phone:518-482-0464
Practice Address - Fax:518-482-0129
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-19
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390284-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool