Provider Demographics
NPI:1255357125
Name:REED, REGINA D (CNP)
Entity type:Individual
Prefix:MS
First Name:REGINA
Middle Name:D
Last Name:REED
Suffix:
Gender:F
Credentials:CNP
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 188
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-0188
Mailing Address - Country:US
Mailing Address - Phone:740-773-4366
Mailing Address - Fax:740-775-7855
Practice Address - Street 1:257165 WILSON ST
Practice Address - Street 2:
Practice Address - City:COOLVILLE
Practice Address - State:OH
Practice Address - Zip Code:45723-8153
Practice Address - Country:US
Practice Address - Phone:740-846-0008
Practice Address - Fax:740-845-0098
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.07869-NP363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2557344Medicaid
Q42154Medicare UPIN