Provider Demographics
NPI:1225423692
Name:HEMINGWAY, REGINA
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:HEMINGWAY
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 1:794 BLUE SKY RD
Mailing Address - Street 2:
Mailing Address - City:LORIS
Mailing Address - State:SC
Mailing Address - Zip Code:29569-5849
Mailing Address - Country:US
Mailing Address - Phone:843-516-2762
Mailing Address - Fax:
Practice Address - Street 1:794 BLUE SKY RD
Practice Address - Street 2:
Practice Address - City:LORIS
Practice Address - State:SC
Practice Address - Zip Code:29569-5849
Practice Address - Country:US
Practice Address - Phone:843-516-2762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-02
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2472R0900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherRenal Dialysis
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide