MEDICARE: MS. REGINA ARMSTRONG STNA STATED TESTED N

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	374U00000X	Home Health Aide	400124150602	OH

General Provider Information

NPI Number	:	1376835348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. REGINA ARMSTRONG STNA STATED TESTED N

Provider Business Mailing Address
First Line	:	13624 S. PARKWAY
Second Line	:
City	:	GARFIELD HTS.
State	:	OH
Zip	:	44105
Country	:	US
Telephone Number	:	216-365-3429
Fax Number	:

Provider Business Practice Location Address
First Line	:	13624 S. PARKWAY
Second Line	:
City	:	GARFIELD HTS.
State	:	OH
Zip	:	44105
Country	:	US
Telephone Number	:	216-365-3429
Fax Number	:

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

Provider Enumeration Date	:	05/10/2011
Last Update Date	:	05/10/2011

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