Provider Demographics
NPI:1669139960
Name:JEAN-LESTIN, REGINE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:REGINE
Middle Name:
Last Name:JEAN-LESTIN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 TAUNTON GREEN SUITE 5
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-3243
Mailing Address - Country:US
Mailing Address - Phone:508-880-6666
Mailing Address - Fax:508-880-6655
Practice Address - Street 1:30 TAUNTON GREEN SUITE 5
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780
Practice Address - Country:US
Practice Address - Phone:508-880-6666
Practice Address - Fax:508-880-6655
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-21
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2318369363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health