Provider Demographics
NPI:1558306712
Name:ESCHER, REGINA L (CFNP)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:L
Last Name:ESCHER
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:L
Other - Last Name:ESCHER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CFNP
Mailing Address - Street 1:15012 LEMOYNE BLVD
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-5205
Mailing Address - Country:US
Mailing Address - Phone:228-392-5050
Mailing Address - Fax:228-392-5342
Practice Address - Street 1:15012 LEMOYNE BLVD
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39532-5205
Practice Address - Country:US
Practice Address - Phone:228-392-5050
Practice Address - Fax:228-392-5342
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR753324207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS000124298Medicaid
MS500001435Medicare ID - Type UnspecifiedMEDICARE IND PROV #
MSP33189Medicare UPIN