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NPI Code Detail

MEDICARE: REGINA NICHOLSON

MEDICARE:   REGINA  NICHOLSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1538998612
Entity Type Code : Individual
Provider Name (Legal Business Name) : REGINA NICHOLSON
Provider Business Mailing Address
First Line : 239 KEVIN PL
Second Line :
City : TOLEDO
State : OH
Zip : 43610-1561
Country : US
Telephone Number : 318-381-4243
Fax Number :
Provider Business Practice Location Address
First Line : 12677 TALL TIMBER CIR
Second Line :
City : NORTH ROYALTON
State : OH
Zip : 44133-3711
Country : US
Telephone Number : 216-562-7214
Fax Number : 440-457-7088
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2024
Last Update Date : 07/29/2024

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