Provider Demographics
NPI:1013456599
Name:STANLEY, REGAN LEA (LPN)
Entity Type:Individual
Prefix:
First Name:REGAN
Middle Name:LEA
Last Name:STANLEY
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 1:1159 COOKS HILL RD LOT 12
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-3710
Mailing Address - Country:US
Mailing Address - Phone:740-637-0358
Mailing Address - Fax:
Practice Address - Street 1:570 PARSONS AVE
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-2938
Practice Address - Country:US
Practice Address - Phone:740-637-0358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.158941164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse