Provider Demographics
NPI:1407014327
Name:HAIGHT, REGINA DAWN (APRN)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:DAWN
Last Name:HAIGHT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 N CAPITOL AVE
Mailing Address - Street 2:C-3
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-1203
Mailing Address - Country:US
Mailing Address - Phone:317-962-0892
Mailing Address - Fax:317-962-6322
Practice Address - Street 1:1701 N CAPITOL AVE
Practice Address - Street 2:C-3
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-1203
Practice Address - Country:US
Practice Address - Phone:317-962-0892
Practice Address - Fax:317-962-6322
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71002536A364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health