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Individual

MRS. REGINA G CODY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP-BC

Contact information

Practice address
1067 PEACHTREE ST, LOUISVILLE, GA 30434-1599
(478) 625-7000
(478) 625-8907
Mailing address
19 LESTER RD, STATESBORO, GA 30458-2119
(912) 662-6501
(912) 681-1012

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0364455
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2009008422
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
976152836D
GA
Enumeration date
11/01/2006
Last updated
04/21/2025
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