Provider Demographics
NPI:1467873125
Name:REGLEIN, TRISTA
Entity Type:Individual
Prefix:MRS
First Name:TRISTA
Middle Name:
Last Name:REGLEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 DREW ST
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3913
Mailing Address - Country:US
Mailing Address - Phone:410-222-4438
Mailing Address - Fax:410-222-4323
Practice Address - Street 1:1950 DREW ST
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3913
Practice Address - Country:US
Practice Address - Phone:410-222-4438
Practice Address - Fax:410-222-4323
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-26
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR157943163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health