Individual
REGINA M ELDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1871 US HIGHWAY 41A S, DIXON, KY 42409-9448
(270) 639-9440
(270) 639-9446
Mailing address
PO BOX 23229, OWENSBORO, KY 42304-3229
(270) 639-9440
(270) 639-9446
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4657P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000380663
BCBS PROVIDER NUMBER
—
01
—
4657P
LICENSE
KY
05
—
78015179
—
KY
Enumeration date
09/17/2006
Last updated
09/01/2015
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