Provider Demographics
NPI:1437129897
Name:REGAN, BARBARA ANNE (PA-C)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANNE
Last Name:REGAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1197 VAN VOORHIS RD
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-3478
Mailing Address - Country:US
Mailing Address - Phone:304-599-9400
Mailing Address - Fax:304-599-8917
Practice Address - Street 1:900 FAIRMONT RD
Practice Address - Street 2:
Practice Address - City:WESTOVER
Practice Address - State:WV
Practice Address - Zip Code:26501-3847
Practice Address - Country:US
Practice Address - Phone:304-292-7316
Practice Address - Fax:304-296-4408
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV453363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV970008643OtherRAILROAD MEDICARE
WVPA11571Medicare PIN