Provider Demographics
NPI:1649880162
Name:ENGLAND, REGINA A
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:A
Last Name:ENGLAND
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 1:15 AMANDA LANE
Mailing Address - Street 2:
Mailing Address - City:MOUNT GAY
Mailing Address - State:WV
Mailing Address - Zip Code:25637
Mailing Address - Country:US
Mailing Address - Phone:304-300-4513
Mailing Address - Fax:
Practice Address - Street 1:15 AMANDA LANE
Practice Address - Street 2:
Practice Address - City:MOUNT GAY
Practice Address - State:WV
Practice Address - Zip Code:25637
Practice Address - Country:US
Practice Address - Phone:304-300-4513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-10
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant