Individual
MS. REGINA R. JASIEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
211 N EDDY ST, SOUTH BEND, IN 46617-2808
(574) 237-9231
(574) 237-9208
Mailing address
211 N EDDY ST, SOUTH BEND, IN 46617-2808
(574) 237-9231
(574) 237-9208
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71000519A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200191990A
—
IN
Enumeration date
07/21/2005
Last updated
09/07/2016
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