Individual
MRS. STEPHANIE A REAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
124 E MAIN ST, MUNCIE, IN 47305-2839
(765) 587-7311
Mailing address
124 E MAIN ST, MUNCIE, IN 47305-2839
(765) 587-7311
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71001099A
IN
363LA2200X
Adult Health Nurse Practitioner
71001099A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000362853
ANTHEM BCBS
IN
01
—
000000626434
ANTHEM BC/BS
IN
01
—
000000668347
ANTHEM BC/BS
IN
05
—
200508380
—
IN
01
—
708472000
UNITED BEHAVIORAL HEALTH
—
Enumeration date
05/12/2006
Last updated
05/16/2022
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