Provider Demographics
NPI:1033735170
Name:SAYLES, REGENIA ELIZABETH (MED-TECH/ CPR)
Entity Type:Individual
Prefix:MS
First Name:REGENIA
Middle Name:ELIZABETH
Last Name:SAYLES
Suffix:
Gender:F
Credentials:MED-TECH/ CPR
Other - Prefix:MS
Other - First Name:REGENIA
Other - Middle Name:ELIZABETH
Other - Last Name:SAYLES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MED-TECH/CPR/AID
Mailing Address - Street 1:5119 SUITLAND RD APT104
Mailing Address - Street 2:
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746
Mailing Address - Country:US
Mailing Address - Phone:240-273-6829
Mailing Address - Fax:
Practice Address - Street 1:3924 MINNESOTA AVE NE WASHINGTON
Practice Address - Street 2:
Practice Address - City:DC
Practice Address - State:DC
Practice Address - Zip Code:20019
Practice Address - Country:US
Practice Address - Phone:202-715-7962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMT0056080374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC70003953OtherAMERIGROUP
DC70003953Medicaid