Provider Demographics
NPI:1477928679
Name:MASH, REGINA L (CNM, APRN)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:L
Last Name:MASH
Suffix:
Gender:F
Credentials:CNM, APRN
Other - Prefix:
Other - First Name:REGINA
Other - Middle Name:L
Other - Last Name:FOUST
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:COMMUNITY MEDICAL ASSOCIATES INC
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5339
Practice Address - Street 1:4123 DUTCHMANS LN STE 601
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207
Practice Address - Country:US
Practice Address - Phone:502-423-9595
Practice Address - Fax:502-719-0161
Is Sole Proprietor?:No
Enumeration Date:2015-12-14
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN09000453C367A00000X
KY3009943367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife