REGINA MIYOUNG PARK AGACNP-BC NPI 1093170318

NPI Information

  • NPI: 1093170318
  • Provider Name: REGINA MIYOUNG PARK, AGACNP-BC
  • Classification: Nurse Practitioner - 363LA2100X
  • Specialization: Acute Care
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2139 AUBURN AVE
    CINCINNATI, OH
    ZIP 45219
  • Phone: (513) 585-4157

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NPI Details

Regina Miyoung Park, AGACNP-BC is an acute care nurse practitioner in Cincinnati, OH with 11 years of experience. Regina Miyoung Park, AGACNP-BC NPI is 1093170318. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: VANDERBILT UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2015

The provider's business location address is:

2139 AUBURN AVE
CINCINNATI, OH
ZIP 45219-906
Phone: (513) 585-4157
Fax: (513) 585-4244

The NPI 1093170318 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/31/2015 and was last updated on 1/9/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LA2200XNurse PractitionerAdult HealthAPRN.CNP.022288OHIONo
2363LA2100XNurse PractitionerAcute CareAPRN.CNP.022288OHIOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10281246MEDICAIDOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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