Provider Demographics
NPI:1518191634
Name:BYRD, REGINA S (LPN)
Entity Type:Individual
Prefix:MS
First Name:REGINA
Middle Name:S
Last Name:BYRD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 SEAGER ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-2140
Mailing Address - Country:US
Mailing Address - Phone:585-473-2921
Mailing Address - Fax:
Practice Address - Street 1:44 SEAGER ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-2140
Practice Address - Country:US
Practice Address - Phone:585-473-2921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY273331164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse