Provider Demographics
NPI:1588011050
Name:HUTCHINS, REGENIA DURWOOD (NP)
Entity Type:Individual
Prefix:
First Name:REGENIA
Middle Name:DURWOOD
Last Name:HUTCHINS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 GORDON AVE
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-6646
Mailing Address - Country:US
Mailing Address - Phone:229-233-8315
Mailing Address - Fax:229-233-0412
Practice Address - Street 1:2691 FREDONIA RD
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31757-1038
Practice Address - Country:US
Practice Address - Phone:229-221-8369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-15
Last Update Date:2019-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN073692363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily