Provider Demographics
NPI:1780680116
Name:FRANCO, REGINA A (ANP, MSN)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:A
Last Name:FRANCO
Suffix:
Gender:F
Credentials:ANP, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8603
Mailing Address - Fax:
Practice Address - Street 1:900 W FARIS RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4255
Practice Address - Country:US
Practice Address - Phone:864-455-7070
Practice Address - Fax:864-454-4669
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC48363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00729163OtherRAIL ROAD MEDICARE
SCNP0185Medicaid
NC7004439Medicaid
NC7004439Medicaid
SC5172Medicare PIN
SC6521Medicare PIN
SC6499Medicare PIN
SCQ31091Medicare UPIN
SC7183Medicare PIN