Provider Demographics
NPI:1942602511
Name:BYRD, REGINA (RN)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:BYRD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1149
Mailing Address - Street 2:
Mailing Address - City:NEBO
Mailing Address - State:NC
Mailing Address - Zip Code:28761-0964
Mailing Address - Country:US
Mailing Address - Phone:828-655-3231
Mailing Address - Fax:828-559-0881
Practice Address - Street 1:3100 HWY 226 S
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:NC
Practice Address - Zip Code:28752-8741
Practice Address - Country:US
Practice Address - Phone:828-655-3231
Practice Address - Fax:828-559-0881
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-25
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC158987163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse