Provider Demographics
NPI:1366057838
Name:NORRIS, REGINA
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:NORRIS
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 1:103 BLUESTONE CT
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-8099
Mailing Address - Country:US
Mailing Address - Phone:202-717-2236
Mailing Address - Fax:
Practice Address - Street 1:3744 HAYES ST NE APT 1
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-1723
Practice Address - Country:US
Practice Address - Phone:202-399-0374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion