Regina Gantt, CSFA - Physician Assistant in Peralta, NM

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Regina Gantt, CSFA is a Physician Assistant - Surgical based in Peralta, New Mexico. Regina Gantt is licensed to practice in * (Not Available) (license number ) and her current practice location is 28 Valle Lindo Road, Peralta, New Mexico. She can be reached at her office (for appointments etc.) via phone at (505) 280-5326.

NPI number for Regina Gantt is 1396121505 and her current mailing address is 28 Valle Lindo Road, Peralta, New Mexico. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1396121505.

Contact Information

Regina Gantt, CSFA
28 Valle Lindo Road,
Peralta, NM 87042
(505) 280-5326
(505) 848-5008

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Provider's Profile

Full NameRegina Gantt
GenderFemale
SpecialityPhysician Assistant - Surgical
Location28 Valle Lindo Road, Peralta, New Mexico
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1396121505
  • Provider Enumeration Date: 08/11/2015
  • Last Update Date: 01/13/2016

Medical Identifiers

Medical identifiers for Regina Gantt such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1396121505NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363AS0400XPhysician Assistant - Surgical (* (Not Available))Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Regina Gantt is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Regina Gantt, CSFA
28 Valle Lindo Road,
Peralta, NM 87042

Ph: (505) 280-5326		Regina Gantt, CSFA
28 Valle Lindo Road,
Peralta, NM 87042

Ph: (505) 280-5326

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