Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Regina Patrick

Individual provider Family Nurse Practitioner · NPI 1891517942

Regina Patrick is a Nurse Practitioner in Montclair, New Jersey. Qualified in 2024, 2 years ago. Practices as a sole proprietor. Licensed in New Jersey.

Years since qualifying
2
Licensed in
NJ
In the registry since
2024

Practice location Address checks out

1 Bay Ave
Montclair, NJ 07042-4837
Phone: (973) 429-6000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 26NJ151182400 (NJ)

Record details

NPI number1891517942
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 29, 2024
Last updated in NPPESOctober 29, 2024
Certification dateOctober 29, 2024
Mailing address762 Seaport Dr, Elizabeth, NJ 07201-3385

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

Other providers in Montclair