Individual
DR. REGINA WILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
313 SOUTH AVE, FANWOOD, NJ 07023-1364
(908) 889-1900
Mailing address
75 LAWRENCE RD, RANDOLPH, NJ 07869-3100
(201) 704-3486
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
26NJ00139500
NJ
Other
Enumeration date
12/01/2006
Last updated
12/08/2021
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