Provider Demographics
NPI:1427788678
Name:FEEKS, REGINA ELIZABETH (PA)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:ELIZABETH
Last Name:FEEKS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 CARDAMON DR
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:MD
Mailing Address - Zip Code:21037-1126
Mailing Address - Country:US
Mailing Address - Phone:443-994-1469
Mailing Address - Fax:
Practice Address - Street 1:130 CARDAMON DR
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:MD
Practice Address - Zip Code:21037-1126
Practice Address - Country:US
Practice Address - Phone:410-271-2854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-12
Last Update Date:2022-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant