Provider Demographics
NPI:1912095209
Name:DRIVER, REGINA STOPHER (MED CCC A)
Entity Type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:STOPHER
Last Name:DRIVER
Suffix:
Gender:F
Credentials:MED CCC A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 A NEFF AVENUE
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3482
Mailing Address - Country:US
Mailing Address - Phone:540-432-0071
Mailing Address - Fax:540-432-6079
Practice Address - Street 1:243 A NEFF AVENUE
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3482
Practice Address - Country:US
Practice Address - Phone:540-432-0071
Practice Address - Fax:540-432-6079
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2101000717237700000X
VA2201000511237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA106786OtherANTHEM INS
VA187481OtherANTHEM
VA118844OtherOPTIMA INS
VA009106634Medicaid
103691400OtherACS DEPARTMENT OF LABOR
VA49486OtherOPTIMA INS
VA148358OtherSOUTHERN HEALTH INSURANCE
VA009450602Medicaid