Provider Demographics
NPI:1831349703
Name:REAGAN, MIRRIN E (RN, NP)
Entity type:Individual
Prefix:
First Name:MIRRIN
Middle Name:E
Last Name:REAGAN
Suffix:
Gender:F
Credentials:RN, NP
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Other - First Name:
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Mailing Address - Street 1:5909 PEACHTREE DUNWOODY RD NE
Mailing Address - Street 2:STE 720
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-8102
Mailing Address - Country:US
Mailing Address - Phone:770-928-2276
Mailing Address - Fax:770-592-2092
Practice Address - Street 1:5909 PEACHTREE DUNWOODY RD NE
Practice Address - Street 2:STE 720
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-8102
Practice Address - Country:US
Practice Address - Phone:770-928-2276
Practice Address - Fax:770-592-2092
Is Sole Proprietor?:No
Enumeration Date:2008-09-26
Last Update Date:2008-09-26
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Provider Licenses
StateLicense IDTaxonomies
GARN150756363LW0102X, 364SP1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No364SP1700XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPerinatal