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Individual

REGGIE MICHAEL GILLINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
355 N MAIN ST, KANAB, UT 84741-3260
(435) 644-4100
(435) 644-3366
Mailing address
PO BOX 5010, MINOT, ND 58702-5010

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
7013719-4405
UT
363LF0000X
Family Nurse Practitioner
Primary
R42548
ND
363LF0000X
Family Nurse Practitioner
TAP4963
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
809756
AZ
Enumeration date
04/17/2013
Last updated
09/23/2025
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