Individual
MRS. REGINA M ARDIANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNPC
Contact information
Practice address
1775 THOMPSON RD, COOS BAY, OR 97420
(541) 269-8111
(541) 269-8469
Mailing address
1775 THOMPSON RD, COOS BAY, OR 97420
(541) 269-8111
(541) 269-8469
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201505729NP-PP
OR
Other
Enumeration date
02/06/2007
Last updated
02/03/2020
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