Provider Demographics
NPI:1891510137
Name:OKINE, REGINA
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:OKINE
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 1:6050 POPES CREEK PL
Mailing Address - Street 2:
Mailing Address - City:HAYMARKET
Mailing Address - State:VA
Mailing Address - Zip Code:20169-5422
Mailing Address - Country:US
Mailing Address - Phone:703-565-3903
Mailing Address - Fax:
Practice Address - Street 1:6050 POPES CREEK PL
Practice Address - Street 2:
Practice Address - City:HAYMARKET
Practice Address - State:VA
Practice Address - Zip Code:20169-5422
Practice Address - Country:US
Practice Address - Phone:703-565-3903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA11001421343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)