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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

REGINA GANTT, CSFA

Active Sole Proprietor

REGINA GANTT, CSFA is a Surgical Physician Assistant healthcare provider located in PERALTA, New Mexico. NPI 1396121505 is currently active in the NPPES registry. Verify at CMS.

Surgical Physician Assistant · PERALTA, NM

Registration Details

NPI Number
1396121505
Provider Type
Individual
Gender
Female
NPI Issued
Aug 11, 2015 (10.964917724547 yrs)
Last Updated
Jan 13, 2016
Sole Proprietor
Yes

Practice Information

Address
28 VALLE LINDO ROAD
PERALTA, NM, 87042
Browse NM providers · Browse ZIP 87042
Phone
5052805326
Fax
5058485008
Primary Specialty
Surgical Physician Assistant
363AS0400X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.