Provider Demographics
NPI:1316269871
Name:ROBISON, REGINA ELISE (APRN)
Entity type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:ELISE
Last Name:ROBISON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2363 LYCE DUNCAN RD
Mailing Address - Street 2:
Mailing Address - City:DIXON
Mailing Address - State:KY
Mailing Address - Zip Code:42409-9761
Mailing Address - Country:US
Mailing Address - Phone:270-213-0094
Mailing Address - Fax:270-639-9499
Practice Address - Street 1:306 US HIGHWAY 41A S
Practice Address - Street 2:
Practice Address - City:DIXON
Practice Address - State:KY
Practice Address - Zip Code:42409-9427
Practice Address - Country:US
Practice Address - Phone:270-213-3635
Practice Address - Fax:270-213-5015
Is Sole Proprietor?:No
Enumeration Date:2010-02-24
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3006673363L00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner