Provider Demographics
NPI:1518568047
Name:SHEARER, REGINA A
Entity Type:Individual
Prefix:MS
First Name:REGINA
Middle Name:A
Last Name:SHEARER
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 1:180 DIANA LN N
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-4408
Mailing Address - Country:US
Mailing Address - Phone:937-318-9979
Mailing Address - Fax:
Practice Address - Street 1:180 DIANA LN N
Practice Address - Street 2:
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324-4408
Practice Address - Country:US
Practice Address - Phone:937-318-9979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care