Healthcare Provider Details

I. General information

NPI: 1427201060
Provider Name (Legal Business Name): REGINA A. BIAS PNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2008
Last Update Date: 05/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E MCDONALD AVE
MAN WV
25635-1023
US

IV. Provider business mailing address

PO BOX 176
LOGAN WV
25601-0176
US

V. Phone/Fax

Practice location:
  • Phone: 304-583-6541
  • Fax: 304-583-6018
Mailing address:
  • Phone: 304-792-7130
  • Fax: 304-896-5184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0200X
TaxonomyPediatric Clinical Nurse Specialist
License Number37921
License Number StateWV

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: