Provider Demographics
NPI:1508588096
Name:KNOTT, REGINA KAMARO (CNA)
Entity Type:Individual
Prefix:MS
First Name:REGINA
Middle Name:KAMARO
Last Name:KNOTT
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5409 E 134TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44125-3211
Mailing Address - Country:US
Mailing Address - Phone:216-931-6241
Mailing Address - Fax:
Practice Address - Street 1:5409 E 134TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44125-3211
Practice Address - Country:US
Practice Address - Phone:216-931-6241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401183071210376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide