Provider Demographics
NPI:1124839709
Name:PIERCE, REGINA RAYE
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:RAYE
Last Name:PIERCE
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 1:1840 N 20TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68110-2304
Mailing Address - Country:US
Mailing Address - Phone:402-739-4425
Mailing Address - Fax:
Practice Address - Street 1:1840 N 20TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68110-2304
Practice Address - Country:US
Practice Address - Phone:402-739-4425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide