MEDICARE: MRS. REGINA ELLEN WILLIG RN

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
1	163W00000X	Registered Nurse	RN228206	OH

General Provider Information

NPI Number	:	1205713195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. REGINA ELLEN WILLIG RN

Provider Business Mailing Address
First Line	:	1471 LINNEMAN RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-1941
Country	:	US
Telephone Number	:	513-347-0415
Fax Number	:

Provider Business Practice Location Address
First Line	:	5358 MANORTREE CT
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-3615
Country	:	US
Telephone Number	:	513-347-0415
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2025
Last Update Date	:	08/20/2025

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