Provider Demographics
NPI:1740781483
Name:DANCE, REGINA ANN (APRN)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:ANN
Last Name:DANCE
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11612 CHAPMAN HWY UNIT B
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:TN
Mailing Address - Zip Code:37865-5083
Mailing Address - Country:US
Mailing Address - Phone:423-888-8506
Mailing Address - Fax:423-888-8506
Practice Address - Street 1:11612 CHAPMAN HWY UNIT B
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:TN
Practice Address - Zip Code:37865-5083
Practice Address - Country:US
Practice Address - Phone:423-888-8506
Practice Address - Fax:423-888-8506
Is Sole Proprietor?:No
Enumeration Date:2018-02-27
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN23937363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty