Provider Demographics
NPI:1184596165
Name:PUTMAN, REGENIA (LPN)
Entity type:Individual
Prefix:
First Name:REGENIA
Middle Name:
Last Name:PUTMAN
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 1:648 W COURT ST APT 2
Mailing Address - Street 2:
Mailing Address - City:BEATRICE
Mailing Address - State:NE
Mailing Address - Zip Code:68310-3608
Mailing Address - Country:US
Mailing Address - Phone:402-729-6104
Mailing Address - Fax:
Practice Address - Street 1:703 K ST
Practice Address - Street 2:
Practice Address - City:FAIRBURY
Practice Address - State:NE
Practice Address - Zip Code:68352-2199
Practice Address - Country:US
Practice Address - Phone:402-729-6104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-19
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE28347164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse