Provider Demographics
NPI:1659798924
Name:REGNER, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:REGNER
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:PO BOX 273
Mailing Address - Street 2:
Mailing Address - City:NAPOLEON
Mailing Address - State:ND
Mailing Address - Zip Code:58561
Mailing Address - Country:US
Mailing Address - Phone:701-754-2283
Mailing Address - Fax:
Practice Address - Street 1:301 BROADWAY
Practice Address - Street 2:
Practice Address - City:NAPOLEON
Practice Address - State:ND
Practice Address - Zip Code:58561-7010
Practice Address - Country:US
Practice Address - Phone:701-754-2283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1440171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator