Provider Demographics
NPI:1215658653
Name:REGIONE, KATRESSA SUZANNE
Entity type:Individual
Prefix:
First Name:KATRESSA
Middle Name:SUZANNE
Last Name:REGIONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATRESSA
Other - Middle Name:SUZANNE
Other - Last Name:PINNON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 6610
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85246-6610
Mailing Address - Country:US
Mailing Address - Phone:480-307-8440
Mailing Address - Fax:
Practice Address - Street 1:21323 S ELLSWORTH LOOP RD STE 101
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-9865
Practice Address - Country:US
Practice Address - Phone:480-307-8440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-05
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ253643163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty