Individual
MRS. REGINA JO ROCZNIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2704 HENRY ST, GREENSBORO, NC 27405-3633
(336) 621-3777
(336) 621-8374
Mailing address
1200 N ELM ST, GREENSBORO, NC 27401-1004
(336) 832-7000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-02313
NC
363AS0400X
Surgical Physician Assistant
Primary
0010-02313
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2762327
MEDICARE PTAN
NC
Enumeration date
01/03/2007
Last updated
01/15/2014
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