Provider Demographics
NPI:1275764342
Name:HALL, REGINA NICHOLE (RN)
Entity Type:Individual
Prefix:MS
First Name:REGINA
Middle Name:NICHOLE
Last Name:HALL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7201 IRISH ROSE LN
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-7779
Mailing Address - Country:US
Mailing Address - Phone:614-348-2707
Mailing Address - Fax:
Practice Address - Street 1:7201 IRISH ROSE LANE
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-7779
Practice Address - Country:US
Practice Address - Phone:614-348-2707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN317577163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse