Provider Demographics
NPI:1619443876
Name:GAKINYA, REGINA NJERI
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:NJERI
Last Name:GAKINYA
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 1:8405 CARTER ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-4464
Mailing Address - Country:US
Mailing Address - Phone:913-319-9712
Mailing Address - Fax:913-499-8794
Practice Address - Street 1:9557 W 87TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-4552
Practice Address - Country:US
Practice Address - Phone:913-499-8693
Practice Address - Fax:913-499-8794
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS9129487OtherBUSINESS ID NUMBER