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Individual

MRS. CARLY ANNE PEELER REGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
6915 VILLAGE MEDICAL CIR, CLEMMONS, NC 27012-8002
(336) 718-1680
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(336) 718-1680
(336) 718-1681

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5005579
NC
363LA2200X
Adult Health Nurse Practitioner
5005579
NC

Other

Enumeration date
03/29/2012
Last updated
03/11/2022
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