MEDICARE: REGINA WILLIAMS

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	251J00000X	Nursing Care Agency	501002961109	OH

General Provider Information

NPI Number	:	1346888120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REGINA WILLIAMS

Provider Business Mailing Address
First Line	:	318 N COOPER AVE
Second Line	:
City	:	LOCKLAND
State	:	OH
Zip	:	45215-2921
Country	:	US
Telephone Number	:	513-344-1109
Fax Number	:

Provider Business Practice Location Address
First Line	:	318 N COOPER AVE
Second Line	:
City	:	LOCKLAND
State	:	OH
Zip	:	45215-2921
Country	:	US
Telephone Number	:	513-344-1109
Fax Number	:

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

Provider Enumeration Date	:	12/12/2019
Last Update Date	:	12/12/2019

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Directions to “ REGINA WILLIAMS ” Practice Location

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