Provider Demographics
NPI:1043758063
Name:KNOX, REGINA J (MPH, CHES)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:J
Last Name:KNOX
Suffix:
Gender:F
Credentials:MPH, CHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:36744-1418
Mailing Address - Country:US
Mailing Address - Phone:409-877-2105
Mailing Address - Fax:
Practice Address - Street 1:800 HALL ST
Practice Address - Street 2:SUITE C
Practice Address - City:GREENSBORO
Practice Address - State:AL
Practice Address - Zip Code:36744-2517
Practice Address - Country:US
Practice Address - Phone:205-614-6211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20625174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator