Provider Demographics
NPI:1003193491
Name:DARLING, REGINA GAYLE
Entity Type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:GAYLE
Last Name:DARLING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1796
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:AR
Mailing Address - Zip Code:72730-1796
Mailing Address - Country:US
Mailing Address - Phone:479-225-3469
Mailing Address - Fax:
Practice Address - Street 1:15951 CHERRY CIRCLE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72704-1796
Practice Address - Country:US
Practice Address - Phone:479-225-3469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR053135390199E374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide