Provider Demographics
NPI:1003625195
Name:ROBERTS, REGINA LYNN (RN, CHS, CNHP, D PS)
Entity type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:LYNN
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:RN, CHS, CNHP, D PS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 CLAY DR
Mailing Address - Street 2:
Mailing Address - City:POUNDING MILL
Mailing Address - State:VA
Mailing Address - Zip Code:24637-4320
Mailing Address - Country:US
Mailing Address - Phone:276-345-6548
Mailing Address - Fax:
Practice Address - Street 1:226 CLAY DR
Practice Address - Street 2:
Practice Address - City:POUNDING MILL
Practice Address - State:VA
Practice Address - Zip Code:24637-4320
Practice Address - Country:US
Practice Address - Phone:276-345-6548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-02
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001137015163WW0000X, 163WX0200X, 1744R1102X, 163W00000X, 163WN1003X, 163WP0000X, 163WP0808X, 163WR0400X, 101YP1600X, 163WC0200X, 163WH0200X, 163WI0500X, 163WE0003X, 163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163WX0200XNursing Service ProvidersRegistered NurseOncology
No1744R1102XOther Service ProvidersSpecialistResearch StudyGroup - Multi-Specialty
No163WN1003XNursing Service ProvidersRegistered NurseNutrition Support
No163WP0000XNursing Service ProvidersRegistered NursePain Management
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice