Provider Demographics
NPI:1891000295
Name:BROWN, REGINA L (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:REGINA
Middle Name:L
Last Name:BROWN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:REGINA
Other - Middle Name:
Other - Last Name:VASTOLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARM D
Mailing Address - Street 1:71041 HIGHWAY 21
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-7120
Mailing Address - Country:US
Mailing Address - Phone:985-875-0715
Mailing Address - Fax:985-875-9728
Practice Address - Street 1:71041 HIGHWAY 21
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-7120
Practice Address - Country:US
Practice Address - Phone:985-875-0715
Practice Address - Fax:985-875-9728
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA017320183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist