Provider Demographics
NPI:1679618953
Name:REGAN, JULIA ANN (OD)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:ANN
Last Name:REGAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8155 PINE DR
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:CO
Mailing Address - Zip Code:81069-8813
Mailing Address - Country:US
Mailing Address - Phone:719-489-2979
Mailing Address - Fax:
Practice Address - Street 1:8155 PINE DR
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:CO
Practice Address - Zip Code:81069-8813
Practice Address - Country:US
Practice Address - Phone:719-250-1266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1414152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist