Provider Demographics
NPI:1164479879
Name:STILLS, REGINA LYNEA (MS, PA-C)
Entity Type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:LYNEA
Last Name:STILLS
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Gender:F
Credentials:MS, PA-C
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Mailing Address - Street 1:18101 LORAIN AVENUE, CLEVELAND CLINIC-FAIRVIEW HOSPITAL
Mailing Address - Street 2:EMERGENCY SERVICES
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-5612
Mailing Address - Country:US
Mailing Address - Phone:216-476-7312
Mailing Address - Fax:216-476-7738
Practice Address - Street 1:18101 LORAIN AVENUE, CLEVELAND CLINIC-FAIRVIEW HOSPITAL
Practice Address - Street 2:EMERGENCY SERVICES
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-5612
Practice Address - Country:US
Practice Address - Phone:216-476-7312
Practice Address - Fax:216-476-7738
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-28
Last Update Date:2018-06-28
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Provider Licenses
StateLicense IDTaxonomies
OH50002265363A00000X
OH5002265363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHQ43348Medicare UPIN