Provider Demographics
NPI:1922338003
Name:REGANICK, DIANE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:
Last Name:REGANICK
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1122 BARBARA ST
Mailing Address - Street 2:
Mailing Address - City:DUQUESNE
Mailing Address - State:PA
Mailing Address - Zip Code:15110-1935
Mailing Address - Country:US
Mailing Address - Phone:412-469-8307
Mailing Address - Fax:
Practice Address - Street 1:1122 BARBARA ST
Practice Address - Street 2:
Practice Address - City:DUQUESNE
Practice Address - State:PA
Practice Address - Zip Code:15110-1935
Practice Address - Country:US
Practice Address - Phone:412-469-8307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-12
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN093695L164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse