Provider Demographics
NPI:1104189596
Name:DORSEY, REGINA
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:DORSEY
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 1:3693 JAY STREET, N.E.
Mailing Address - Street 2:APT. #302
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019
Mailing Address - Country:US
Mailing Address - Phone:202-705-9907
Mailing Address - Fax:
Practice Address - Street 1:3693 JAY STREET, N.E.
Practice Address - Street 2:APT. #302
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019
Practice Address - Country:US
Practice Address - Phone:202-705-9907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide