Individual
REGAN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2613 S MAIN ST STE D, JOPLIN, MO 64804-2678
(417) 553-7920
Mailing address
2613 S MAIN ST STE D, JOPLIN, MO 64804-2678
(417) 553-7920
(877) 464-5922
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2019006014
MO
363LF0000X
Family Nurse Practitioner
76805
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2007017822
RN
—
Enumeration date
06/11/2015
Last updated
09/25/2025
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