Healthcare Provider Details

I. General information

NPI: 1427223254
Provider Name (Legal Business Name): MS. REGINA M MAYS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TRACY A CROSS RN

II. Dates (important events)

Enumeration Date: 04/23/2008
Last Update Date: 04/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 S REYNOLDS RD STE A
TOLEDO OH
43615-6953
US

IV. Provider business mailing address

347 S REYNOLDS RD STE A
TOLEDO OH
43615-6953
US

V. Phone/Fax

Practice location:
  • Phone: 419-535-5911
  • Fax: 419-535-5988
Mailing address:
  • Phone: 419-535-5911
  • Fax: 419-535-5988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number1753148
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number1753148
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: