Individual
MRS. REGINA CLARK CANTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-5887
(706) 721-8623
Mailing address
950 15TH ST, AUGUSTA, GA 30901-2608
(706) 733-0188
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN101517
GA
Other
Enumeration date
03/13/2017
Last updated
10/09/2025
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