Macy, Regina

Macy, Regina is an individual health care provider with primary practice located at 514 W 2Nd St , Bloomington IN 47403-2316. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Macy, Regina can be contacted via phone (812) 353-3719.

Contact Information

Primary practice address
514 W 2Nd St Bloomington IN 47403-2316
Phone: (812) 353-3719
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 71004268A Indiana

Profile Details

NPI number 1356349864
LBN Legal business name Macy, Regina
Credentials Gerontological Nurse Practitioner (GNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2005
Last updated Dec 18th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356349864 NPPES
Indiana MEDICAID 201144540

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