Provider Demographics
NPI:1891233367
Name:REGIS COLLEGE
Entity Type:Organization
Organization Name:REGIS COLLEGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTIONER-PROFESSOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRIKORIAN
Authorized Official - Suffix:
Authorized Official - Credentials:CN
Authorized Official - Phone:781-768-7000
Mailing Address - Street 1:526 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458-2032
Mailing Address - Country:US
Mailing Address - Phone:617-244-2345
Mailing Address - Fax:
Practice Address - Street 1:526 CENTRE ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458-2032
Practice Address - Country:US
Practice Address - Phone:617-244-2345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-05
Last Update Date:2017-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2281019163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, AmbulatoryGroup - Single Specialty