Provider Demographics
NPI:1750706818
Name:REGAN, KIARA MARIE (RN, PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KIARA
Middle Name:MARIE
Last Name:REGAN
Suffix:
Gender:F
Credentials:RN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:36 DEALLYON AVE
Mailing Address - Street 2:APT 111
Mailing Address - City:HILTON HEAD
Mailing Address - State:SC
Mailing Address - Zip Code:29928-7038
Mailing Address - Country:US
Mailing Address - Phone:978-808-2923
Mailing Address - Fax:
Practice Address - Street 1:36 DEALLYON AVE
Practice Address - Street 2:APT 111
Practice Address - City:HILTON HEAD
Practice Address - State:SC
Practice Address - Zip Code:29928-7038
Practice Address - Country:US
Practice Address - Phone:978-808-2923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-26
Last Update Date:2017-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2278153163W00000X, 363LP0808X
GARN237273363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse