Provider Demographics
NPI:1205226867
Name:DEMASI, REGINA (FNP-BC)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:DEMASI
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 EDGWOOD ST
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-5758
Mailing Address - Country:US
Mailing Address - Phone:304-780-5005
Mailing Address - Fax:
Practice Address - Street 1:2596 BATTLE RUN ROAD
Practice Address - Street 2:
Practice Address - City:TRIADELPHIA
Practice Address - State:WV
Practice Address - Zip Code:26059
Practice Address - Country:US
Practice Address - Phone:304-547-2829
Practice Address - Fax:304-547-2929
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-03
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN70767-FNP-BC363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily