Individual
REGINA STEPHANIE EDDIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3285 E SPARROW AVE, FLAGSTAFF, AZ 86004-7794
(928) 773-4152
Mailing address
12880 THREE MAN TRL, FLAGSTAFF, AZ 86004-3004
(928) 526-7931
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN090868
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115486
—
AZ
Enumeration date
05/02/2007
Last updated
07/08/2007
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