Provider Demographics
NPI:1104584630
Name:REGIER, RONALD
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:
Last Name:REGIER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76215 ROAD 336
Mailing Address - Street 2:
Mailing Address - City:MADRID
Mailing Address - State:NE
Mailing Address - Zip Code:69150-4102
Mailing Address - Country:US
Mailing Address - Phone:308-326-4495
Mailing Address - Fax:
Practice Address - Street 1:76215 ROAD 336
Practice Address - Street 2:
Practice Address - City:MADRID
Practice Address - State:NE
Practice Address - Zip Code:69150-4102
Practice Address - Country:US
Practice Address - Phone:308-326-4495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-01
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEG74001677172A00000X
NE3747A0650X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No172A00000XOther Service ProvidersDriver
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider