Provider Demographics
NPI:1063171551
Name:WEST, REGINA D
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:D
Last Name:WEST
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 1:1710 WHITEPOND DR APT 106
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320
Mailing Address - Country:US
Mailing Address - Phone:234-232-4453
Mailing Address - Fax:
Practice Address - Street 1:1338 E FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44502-2703
Practice Address - Country:US
Practice Address - Phone:234-232-4453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-11
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide