REGINA RENEE WILLIS (NPI# 1306904412) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306904412 |
| Entity Type | Individual |
| Full Name | REGINA RENEE WILLIS |
| Credential | N.P. |
| Practice Address |
5015 Shed Rd Ste 500 Bossier City LA 71111-5587 |
| Mailing Address |
5015 Shed Rd Bossier City LA 71111-5584 |
| Practice Telephone | 3187415858 |
| Practice Fax Number | 3187414496 |
| Mailing Telephone | 3187415858 |
| Mailing Fax Number | 3187414496 |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2018-06-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
RN054611 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LX0106X |
Nurse Practitioner Specialization: Occupational Health |
AP05016 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5015 SHED RD STE 500 |
| City | BOSSIER CITY |
| State | LA |
| Zip Code | 71111-5587 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669007951 | Tamara 'tammy' Larck | Counselor | 1525 Fullilove Drive, Shreveport, LA 71111 | 2020-03-06 |
| 1912538315 | Lagniappe Chiropractic | Chiropractor | 2400 Airline Drive, Bossier City, LA 71111 | 2020-02-04 |
| 1649817420 | Lifecare Medical Transportation, LLC. | Non-emergency Medical Transport (VAN) | 25 Duck Haven Pointe, Bossier City, LA 71111 | 2019-11-29 |
| 1770126344 | Bertresea White Evans | Nurse Practitioner | Coastal Urgernt Care, 5314 Airline Drive, Bossier City, LA 71111 | 2019-10-25 |
| 1861964058 | Erika Davis Reed | Counselor | 1515 Doctors Dr # 16, Bossier City, LA 71111 | 2018-12-28 |
| 1518436898 | Charlotte Mckay | Case Manager/Care Coordinator | 31330 Hwy 22, Ste 101, Bossier City, LA 71111 | 2018-11-16 |
| 1992271464 | Np2u, LLC | Nurse Practitioner | 2008 Airline Drive Suite 300 #194, Bossier City, LA 71111 | 2018-10-22 |
| 1114416542 | Lashaunda Autrey | Counselor | 410 Half Moon Lane, Bossier, LA 71111 | 2018-05-01 |
| 1750887196 | Shenya Williams-pennywell | Counselor | 1007 Gould Drive Bldg 2, Suite 1, Bossier City, LA 71111 | 2018-04-04 |
| 1336647304 | Patrick Vance | Physical Therapist | 5000 Benton Rd Ste 1, Bossier City, LA 71111 | 2018-01-24 |
| Find all providers in zip 71111 | ||||
| Taxonomy Code | 363LX0106X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Occupational Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215310453 | Jordan Stein Broussard | Nurse Practitioner | 3301 Old Spanish Trail, Westlake, LA 70669 | 2015-07-07 |
| 1063960433 | Emily Fusilier | Nurse Practitioner | 13406 Airline Hwy, Baton Rouge, LA 70817-5917 | 2016-09-14 |
| City | BOSSIER CITY |
| Zip Code | 71111 |
Please comment or provide details below to improve the information on REGINA RENEE WILLIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.